老年男性原发性高血压病患者脉压与颈动脉病变关系的临床研究  

Relationship between pulse pressure and extracranial carotid arteriosclerosis in elderly men with essential hypertension

作　　者：宋丽清[1] 宋少英 楚卡琳[1] 张萍[1] 薛嫱[1] 

机构地区：[1]北京大学第四临床医学院北京积水潭医院干部保健科,100035 [2]黑龙江省鹤岗市鹤煤集团总医院神经内科

出　　处：《北京医学》2008年第2期84-86,共3页Beijing Medical Journal

摘　　要：目的探讨老年原发性高血压病患者动态脉压与颈动脉狭窄及斑块形成的关系。方法选择149例老年男性原发性高血压病患者进行24h动态血压监测及颅外段颈动脉超声检查,计算颅外段颈动脉斑块指数(PI)。分别以全天平均脉压(PP)第33及第67百分位数(57及67mmHg)为界值,将所有病例分为A、B、C三组,比较各组PI、颈总动脉内膜中层厚度(IMT)及颈总动脉(CCA)狭窄发生率。结果①颈动脉PI与平均收缩压、PP均呈正相关,P<0.01;②A、B、C三组间年龄及颈动脉PI呈上升趋势,C组与A、B组比较有显著性差异;CCA狭窄发生率呈递增趋势,C组与A组比较有显著性差异。③多因素分析显示,年龄(OR19.309,95%CI为2.001～186.306,P<0.05)、PP(OR2.063,95%CI为1.215～3.506,P<0.01)是CCA狭窄的独立危险因素。结论老年男性原发性高血压患者颅外段颈动脉PI与PP显著相关,年龄、PP是颈动脉狭窄的独立危险因素。Objectives To examine the association between carotid artery intima-media thickness （IMT）, plaque, stenosis and average pulse pressure（PP） in elderly men with essential hypertension. Methods One hundred and fory-nine cases were enrolled in the study. All patients underwent ambulatory blood pressure monitoring and extracranial carotid ultrasound examination. Extracranial carotid artery plaque index （PI） was calculated. All the patients were classified into three groups on the basis of PP levels（textiles）： A, B and C group. Results① PI was positively related to PP and average systolic blood pressure （P〈0.01）. ② PI and prevalence of CCA stenosis were toward high with growing tertiles of PP. Patients in C group were older and showed significantly higher PI than those in A and B groups. The prevalence of CCA stenosis in upper（PP） tertile was statistically higher than that in lower tertile. There was a stepwise increase （no significant difference） of IMT with growing tertiles of PP. ③ A multivariate analysis showed that both age （OR 19.309,95% CI 2.001-186.306, P〈0.05） and PP （OR 2.063,95% CI 1.215-3.506, P〈0.01） were independent risk factors of common carotid artery （CCA） stenosis. Conclusions Extracranial carotid artery PI is correlated with PP. Age and PP are independent risk factors of CCA stenosis.

关 键 词：原发性高血压病 脉压 颈动脉 斑块指数 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]