高血压合并脂代谢紊乱对颈动脉重构的影响  

Effects of the Disordered Lipid Metabolism on Carotid Artery Remodelling in Hypertensive Patients

作　　者：陈闽荔[1] 吕建国[1] 关欣[1] 张晶[1] 屈大展[1] 

机构地区：[1]天津市胸科医院心内科,300051

出　　处：《天津医药》2008年第8期575-577,共3页Tianjin Medical Journal

基　　金：天津市卫生局科技基金资助项目(项目编号:05ky27)

摘　　要：目的:观察伴有或不伴有血脂代谢紊乱的高血压患者的颈动脉内膜-中膜厚度(IMT)和颈动脉内径、扩张性及僵硬度,探讨血脂在高血压患者颈动脉重构中的作用。方法:入选对象172例,其中正常对照组50例,高血压血脂正常组62例,高血压血脂紊乱组60例,未服用过他汀类、贝特类及烟酸等调脂药物。通过颈动脉超声测定颈动脉IMT和内径,并计算颈动脉扩张性及颈动脉僵硬度。结果:IMT、内径、僵硬度高血压血脂正常组显著高于正常对照组(P<0.05),高血压血脂紊乱组则高于高血压血脂正常组(P<0.05)。颈动脉扩张性高血压血脂正常组较正常对照组显著降低(P<0.05),高血压血脂紊乱组较高血压血脂正常组也显著降低(P<0.05)。低密度脂蛋白胆固醇(LDL-C)与颈动脉IMT(r=0.318,P<0.01)、内径(r=0.333,P<0.01)呈正相关,高密度脂蛋白胆固醇(HDL-C)与颈动脉IMT及内径无明显相关(r分别为0.038和0.078,均P>0.05)。结论:高血压合并血脂紊乱可对颈动脉重构起到促进作用,其中LDL-C升高型血脂代谢紊乱影响更为显著,而HDL-C与颈动脉重构无明显相关。Objective：To investigate the effects of the disordered lipid metabolism on carotid artery remodelling in hypertensive patients. Methods： One hundred and seventy-two people were divided into three groups ： normotention subjects（ n = 50）; hypertensive subjects without disordered lipid metabolism （ n = 62）; hypertensive subjects with disordered lipid metabolism （ n = 60）. The intima - media thickness （IMT） and diameter were measured by high resolusion B - mode ultrasound in 172 subjects to disscus the relationship between LDL-C, HDL-C and IMT, diameter. Results： There was no significant difference in sex, age, smoking history,drinking history and body mass index in three groups （ P 〉 0.05）. IMT, diameter and stiffness of the hypertensive subjects without disordered lipid metabolism were higher than that of normal subjects. IMT, diameter and stiffness of the hypertensive subjects with disordered lipid metabolism were higher than that of hypertensive subjects without disordered lipid metabolism. LDL - C had a positive correlation with IMT （r = 0. 318, P〈 0. 01） and diameter （r = 0. 333, P 〈 0.01）of carotid artery ,and HDL - C had not correlation with IMT and ID of carotid artery（ r = 0.038, P 〉 0.05 ; r = 0.078, P 〉 0.05 ）. Conslusion：The hypertension with disordered lipid metabolism ,especially the high LDL-C,can promote the remodeling of carotid artery.

关 键 词：高血压 颈动脉 血管 脂蛋白类 LDL 胆固醇 脂蛋白类 HDL胆固醇 

分 类 号：R589.205[医药卫生—内分泌] R544.1[医药卫生—内科学]