血压管理对高血压伴颈动脉粥样斑块患者动脉粥样硬化影响的临床研究  

Clinical Research of the Affections of Blood Pressure Management in Hypertension with Carotid Artery Plaque

作　　者：翟莉[1] 胡艳丽[1] 肖洒[1] 王晓瑾[1] 单青[1] 

机构地区：[1]武警北京总队第二医院心血管内科,北京市西城区100037

出　　处：《中国分子心脏病学杂志》2015年第5期1444-1447,共4页Molecular Cardiology of China

摘　　要：目的评价血压管理对高血压伴颈动脉粥样斑块患者动脉粥样硬化的影响。方法治疗2014年1月至2015年5月在我院选择208例高血压伴颈动脉斑块的患者,根据患者服药的依从性将患者分为未按时服药和按时服药两组,常规行颈部血管彩超,分别在出院后3个月,6个月及12个月复查颈部血管彩超,观察坚持服药组和未坚持服药的患者颈部动脉粥样硬化的变化情况。结果坚持服药的患者左侧颈总动脉内膜中层厚度在基线时与服药3个月无变化,6个月时开始降低,由0.102±0.042cm降低到0.088±0.033cm,差别显著,P<0.001。到12个月时进一步降低到0.082±0.026cm,未坚持服药组,左侧颈总动脉内膜厚度在基线时与服药3个月无变化,6个月时开始增加,由0.104±0.043cm升高到0.135±0.036cm,差别显著,P<0.001。到12个月时进一步升高到0.171±0.034cm,差别显著,P<0.001。两组比较,左侧颈总动脉内径在基线时与服药3个月时无明显差别,6个月及12个月时差异显著,P<0.001。坚持按时服药12个月组,右侧颈总动脉内膜厚度在基线时与服药3个月,6个月及12个月时无明显差别。未坚持服药组,右侧颈总动脉内膜厚度在基线时与服药3个月无变化,6个月时开始增加,由0.110±0.043cm升高到0.168±0.036cm,差别显著,P<0.001。到12个月时进一步升高到0.186±0.034cm,P=0.099.两组人,右侧颈总动脉内膜厚度在基线时与服药3个月时无明显差别,6个月及12个月时差异显著,P<0.001,未坚持服药组较坚持服药组显著增加。从而说明坚持血压管理的患者颈动脉粥样硬化明显减轻。结论坚持血压管理可以更好的改善患者的颈动脉粥样硬化,减少脑血管疾病及卒中的风险。Objective Judge the effect of blood pressure management in hypertension with carotid artery plaque. Method Two hundred and eight hospitalized patients who are suffering from hypertension with carotid artery plaque were included. Dividing the participants into two groups by whether they took medicine on time according to their medication compliance and observing the change situations between the two groups by taking carotid ultrasound in three months, six months and twelve months respectively after they were discharged. Results Left common carotid artery intima media thickness（IMT） at baseline of the patients who took medicine on time remained unchanged in the first three months but started to reduce from 0.102±0.042 cm to 0.088±0.033 cm after six months. The difference was significant（P〈0.01） and it got a further reduce to 0.082±0.026 cm twelve months later. For the other group, left common carotid artery IMT also remained unchanged in the first three months, but after six months it started to increase from 0.104±0.043 cm to 0.135±0.036 cm. The difference was significant（P〈0.01） and it got a further increase to 0.171±0.034 cm twelve months later with significant difference still（P〈0.01）. Comparing two groups, the left common carotid artery IMT in the first three months has no obvious difference, but a significant difference arises in six months and twelve months, P〈0.001. Right common carotid artery IMT of the group taking medicine on time in twelve months barely had noticeable difference between taking medicine for three months or six months. Right common carotid artery IMT of the group without taking medicine on time didn＇t change in the first three months, but in six months it increased from 0.110±0.043 cm to 0.168±0.036 cm. The difference was significant（P〈0.01）, and it even further increased to 0.186±0.034 cm, P=0.099 after in twelve months. Statistical difference was not seen in the two groups in three months, but was found in six months and twelve months with signif

关 键 词：血压管理 高血压 颈动脉粥样硬化 

分 类 号：R544.1[医药卫生—心血管疾病] R543.4[医药卫生—内科学]