原发性高血压左室肥厚患者动脉结构和功能改变的临床研究  

Clinical Study on the Structural and Functional Changes of Arteries in Essential Hypertension Patients with Left Ventricular Hypertrophy

作　　者：宋涛[1] 葛志明[1] 巩会萍[1] 蒋桂花[1] 方宁宁[1] 陶文[1] 张运[1] 

机构地区：[1]山东大学教育部和卫生部心血管重构和功能研究重点实验室山东大学齐鲁医院心内科,济南市200512

出　　处：《中国超声医学杂志》2008年第2期123-126,共4页Chinese Journal of Ultrasound in Medicine

基　　金：山东省医药卫生系统1020工程资助项目

摘　　要：目的探讨原发性高血压(EH)伴左室肥厚(LVH)患者动脉重构的特点及两者之间的关系。方法140例受检者入选本研究,其中高血压非左室肥厚(NLVH)50例,高血压伴左室肥厚(LVH)50例,正常对照组40例,分别应用超声评价内皮功能,颈动脉粥样硬化程度和横断面弹性,同时应用动脉硬化检测系统对动脉节段僵硬度及下肢动脉阻塞程度进行评估。结果EH患者与正常人比较肱动脉的内径变化率(ΔD%)及血流量变化率(ΔQ%)明显降低(P<0.05),颈总动脉弹性系数(Ep)及僵硬系数(β)增高,动脉顺应性(AC)降低,颈总动脉内径(CCA-D)、内膜-中层厚度(CCA-IMT)、斑块检出率增加(P<0.05),均以LVH组改变最显著。肱-踝脉搏波传导速度(BaPWV)在LVH组最高,NLVH组次之,均明显高于对照组(P<0.01)。反映下肢动脉阻塞程度的踝-臂指数(ABI)在三组间都在正常范围,无显著性差异(P>0.05)。结论EH患者在出现LVH之前,外周动脉就发生一系列结构和功能的改变,LVH患者动脉重构更明显,因此动脉重构在LVH发生发展中起着重要的作用。Objective To investigate the characteristics of arteries remodling and the relationship between arteries remodling and left ventricular hypertrophy in essential hypertension （EH） patients. Methods A total of 140 subjects were included in our study： 50 hypertension patients without LVH, 50 hypertension patients with LVH and 40 normal subjects. The changes of arterial structure and function were evaluated using ultrasound and arteriosclerosis examination system in all subjects. Results Compared with the normal subjects, the change rates of the internal dameter （△D%） and blood flows （△Q%） in brachial artery was decreased obviouslly in EH patients （P〈0.05） . Ep and β were higher in patients with EH patients than that in the normal subjects, and AC was lower in EH patients （P（0. 05） . The internal diameter, intima-media thickness （IMT） and plaques of the common carotid artery （CCA） were increased significantly in patients with EH patients than those in normal subjects. All indices were changed most significantly in LVH patients. Brachial-ankle pulse wave velocity （BaPWV） was the highest in LVH subjects, and the second was in NLVH patients. Ankle-brachial index （ABI） of the three groups were in the normal range and had no statistical significance （P〉0.05） . Conclusions EH patients have developed the structural and functional changes of peripheral arteries before the appearance of LVH, and artery remodling is more apparent in LVH patients. Therefore, artery remodling may paly an important role in the occurrence and development of LVH.

关 键 词：原发性高血压 左室肥厚 内皮功能障碍 动脉硬化 动脉粥样硬化 

分 类 号：R541.3[医药卫生—心血管疾病] R323.71[医药卫生—内科学]