基于血管功能及结构检测探讨H型高血压病患者的病变特点  

A Study on Lesion Characteristics of Patients with H Type Hypertension Based on Detection of Vascular Function and Structure

作　　者：杜文婷[1] 刘萍[1] 邓兵[1] 章怡祎[1] 张娜[1] 毛美娇[1] 王凤[1] 

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《上海中医药大学学报》2016年第3期12-17,共6页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市科委科研基金资助项目(12401903403);上海中医药大学"远志杯"科创培育项目

摘　　要：目的:通过比较原发性H型高血压病与非H型高血压病患者的血管结构、功能的差异,探讨H型高血压病患者的病变特点。方法:采用流行病学调查方法,纳入150例原发性高血压病患者,根据其是否伴有同型半胱氨酸(homocysteine,Hcy)水平的升高分为H型高血压病组(简称"H型组",90例)和非H型高血压病组(简称"非H型组",60例)。比较两组患者的中医证型及合并基础疾病情况,检测患者的颈动脉内中膜厚度(intima-media thickness,IMT)、斑块大小及分级,脉搏波传导速度(brachial-ankle pulse wave velocit,ba PWV)、踝臂指数(ankle-brachial index,ABI),心脏射血分数(left ventricular ejection fraction,LVEF)、每搏输出量(stroke volume,SV),及血脂、高敏C反应蛋白(hs-CRP)、Hcy水平。结果:与非H型组比较,H型组患者以男性居多,吸烟率更高,伴有心律失常、高脂血症者所占的比例更高,痰湿壅盛证患者更多见(P<0.05)。与非H型组比较,H型组患者的左右两侧ba PWV更高(P<0.05);颈动脉IMT更高,斑块更大、数目更多(P<0.05);高密度脂蛋白(HDL-C)水平更低(P<0.05);Hcy、hs-CRP水平更高(P<0.05)。结论:原发性H型高血压病患者临床以痰湿壅盛型多见,血管弹性较非H型高血压病患者差,血管结构亦发生显著改变,临床中对其防治应予以重视。Objective： To explore the lesion characteristics of patients with H type hypertension through comparing vascular function and structure between H type and non H type primary hypertension. Methods： A total of 150 patients with primary hypertension were divided into the H type hypertension group（ ＂H type group ＂,90 cases） and the non H type hypertension group（ ＂non H type group＂,60 cases） according to the level of blood homocysteine（ hcy）. The Chinese medical syndrome and the basic disease were investigated and compared. The intima-media thickness（ IMT）,plaque area and degree of carotid artery,brachial-ankle pulse wave velocit（ ba PWV）,ankle-brachial index（ ABI）,left ventricular ejection fraction（ LVEF）,stroke volume（ SV） and the levels of blood lipid,hs-CRP and hcy were detected. Results： Compared with the non H type group,the male patients were more than the female patients,the rate of smoking was higher,the proportions of the arhythmia and hyperlipemia patients were higher,and the patients of excessive accumulation of phlegm-dampness syndrome were more in the H type group（ P〈0. 05）. Compared with the non H type group,the ba PWV was higher（ P〈0. 05）; the IMT of carotid artery was thicker,the plaque was bigger and the number of plaque was more（ P〈0. 05）; the level of HDL-C was lower（ P〈0. 05）; the levels of hcy and hs-CRP were higher（ P〈0. 05） in the H type group. Conclusion： Excessive accumulation of phlegm-dampness syndrome is the most common clinical syndrome in the patients with H type hypertension,the vascular elasticity of the patients with H type hypertension is worse than the patients with non H type hypertension,and the vascular structure of the patients with H type hypertension is significantly changed. The prevention and treatment of H type hypertension should be paid attention in clinic.

关 键 词：H型高血压病 血管功能 血管结构 病变特点 

分 类 号：R544.1[医药卫生—心血管疾病]