高血压前期对颈动脉粥样硬化的影响  

Influence of prehypertension on carotid atherosclerosis

作　　者：张军伟[1] 杨颖[2] 王晓春[3] 李海涛[3] 

机构地区：[1]河北联合大学附属医院重症医学科,河北省唐山市063000 [2]河北联合大学附属医院人工肾,河北省唐山市063000 [3]河北联合大学附属医院心内科,河北省唐山市063000

出　　处：《中国综合临床》2015年第7期632-635,共4页Clinical Medicine of China

摘　　要：目的观察高血压前期患者相关危险因素指标变化以及颈动脉内膜的超声表现，并探讨其临床意义。方法选择2012年2月至2014年8月在河北联合大学附属医院进行健康体检的人群中符合纳入标准的人群1152名，分为正常血压组（301名），高血压前期组（378例），高血压组（473例）。所有入选者均接受基本资料调查、血生化检验，并用彩色多普勒超声仪测定入选人群的颈动脉内膜中层厚度（IMT），描述其斑块回声影像。结果3组人群中年龄、性别、腰臀比（WHR）、收缩压、舒张压、空腹血糖（GLU）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）比较，差异均有统计学意义（F值／χ^2值分别为21．54、62．228、36．2634、1846．131、415．82、3．123、43．539、17．757，P均〈0．05）；3组斑块检出率比较差异有统计学意义（χ^2=196．125，P〈0．001），高血压前期组斑块检出率显著高于正常血压组[31．2％与23．3％，P〈0．001]，高血压组斑块检出率显著高于高血压前期组[（68．9％与31．2％，P〈0．001]；3组人群粥样硬化斑块声像特点比较差异有统计学意义（χ^2=32．767，P〈0．05）；Logistic多因素分析显示颈动脉粥样硬化斑块形成与男性、高龄、腹型肥胖、血脂异常和收缩压升高有关（P均〈0．05）。结论高血压前期即存在相关危险因素水平的升高，存在多种代谢异常，在颈动脉粥样硬化斑块形成的进展中发挥关键作用。Objective To observe the changes of the related risk factors and the ultrasound manifestation of carotid intima on carotid atherosclerosis patients and to explore its clinical significance. Methods One thousand one hundred and fifty-two population had been selected in physical examination of the Affiliated Hospital of Hebei United University from February 2012 to June 2014. The population were divided into the normal blood pressure group（ n = 301 ）, prehypertensive group （ n = 378 ） and hypertensive group （ n = 473 ）. All patients were performed basic data questionnaire, blood biochemical examination, the carotid intima-media thickness （IMT）, and artery plaque were measured with echoeardiography. Results The differences of age, gender,waist-to-hipratio （ WHR ）, systolic pressure （ SBP ）, diastolic pressure （ DBP ）, fasting blood-glucose （ GLU）, total cholesterol （ TC ）, triglyceride （TG） and （ low-density lipoprotein cholesterol ） LDL-C among three groups were all statistically significant （ F/χ^2 = 21.54, 62. 228,36. 2634, 1846. 131,415.82, 3. 123,43. 539, 17. 757,P〈 0. 05） ;The IMT and plaque detection rate among three groups had significant difference （χ^2 = 196. 125,P〈0. 01 ）, in pre-hypertension group was significantly higher than that in normal blood pressure group（ 31.2% vs 23.3%, P〈0. 001 ）, in hypertension group was significantly higher than that of pre-hypertension group（ 68.9% vs 31.2%, P 〈 0.001 ）.There were statistically significant differences in the ultrasonic characteristics of the atheroselerotic plaque between the three groups （χ^2= 32. 767, P〈0. 05 ）. Multiple Logistic regression ana/ysis showed that the formation of carotid artery atheroselerotic plaque associated with male, age, abdominal obesity, dyslipidemia and elevated systolic blood pressure （P〈0. 05 ）. Conclusion The existence of pre-hypertension associated with increased levels of risk factors, the presence of multiple metabolic abnormalities, which pla

关 键 词：高血压前期 颈动脉内膜中层厚度 动脉粥样硬化 

分 类 号：R543.4[医药卫生—心血管疾病]