超声评价早期原发性高血压患者血管内皮功能和颈动脉内-中膜厚度及其相关性研究  

Detection of endothelial function and carotid arterial intima-media thicknessin in patients with early essential hypertension using ultrasound

作　　者：帅秀芳[1] 郑慧[1] 王邦宁[2] 江洁[2] 靳松[1] 姚文[1] 姚翀[1] 李晓金[1] 王迪[1] 

机构地区：[1]安徽医科大学第一附属医院超声科,合肥230022 [2]安徽医科大学第一附属医院心血管内科,合肥230022

出　　处：《安徽医科大学学报》2014年第2期248-251,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省高校自然科学基金重点项目(编号:KJ2013A166)

摘　　要：目的探讨早期原发性高血压(EH)患者的血管内皮功能及颈动脉内-中膜厚度(IMT)变化,并分析两者之间相关性。方法应用高频超声诊断仪检测早期EH患者与正常对照者IMT、肱动脉反应性充血前后及舌下含服硝酸甘油后内径的变化,并分析早期EH患者肱动脉内皮依赖性血管扩张(FMD)与IMT相关性。结果早期EH组基础内径与正常对照组比较差异有统计学意义(P<0.05);反应性充血时肱动脉内径变化较正常对照组明显减弱,差异有统计学意义(P<0.01),硝酸甘油介导的肱动脉内径变化与正常对照组比较差异无统计学意义(P>0.05)。IMT较正常对照组增厚,两组比较差异有统计学意义(P<0.01),斑块检出率两组比较差异无统计学意义(P>0.05)。IMT与肱动脉FMD呈负相关(r=-0.679,P<0.01)。结论早期EH患者血管内皮功能受损,IMT较正常对照者明显增厚,FMD与IMT呈负相关。Objective To access the brachial artery endothelium dependent dilation and the carotid arterial intima- media thickness in patients with early essential hypertension （EH） and to analyze the correlation between them. Methods The brachial artery diameter at basic stage, the brachial artery diameter under reactive hyperemia condi- tion,the hraehial artery diameter response to nitroglycerin and the carotid arterial intima-media thickness were measured by high frequency uhrasonography in 35 patients with EH and in 30 normal control subjects. To analyse the correlation between the brachial artery endothelium dependent dilation and the carotid arterial intima-media thickness in patients with early essential hypertension . Results There had significant difference between the two groups in the brachial artery diameter at basic stage （P 〈 0.05）. The increased percentage of the brachial artery di- ameter under reactive hyperemia condition in patients with EH decreased significantly compared with normal control subjects （P 〈0.01 ）. There was no significant difference between the changes in the two groups in response to ni- troglycerin （P 〉 0.05 ）. The IMT in patients with EH diagnosed increased significantly （P 〈 0.05 ）. The rate of the carotid atheromatous plaque had no significant difference from the normal control group （P 〉 0.05 ）. The increased percentage of the brachial artery diameter under reactive hyperemia condition in patients with EH showed a signifi- cant negative correlation with the carotid arterial IMT（r = -0. 646,P 〈 0. 01 ）. Conclusion Endothelium depend- ent dilation is impaired in patients with EH. The IMT increases obviously compared with the normal control sub- jects. The endothelium dependent dilation in patients with EH shows a significant negative correlation with the IMT.

关 键 词：原发性高血压 血管内皮功能 颈动脉内-中膜厚度 高频超声 

分 类 号：R445.12[医药卫生—影像医学与核医学] R544.11[医药卫生—诊断学]