原发性高血压患者肾动脉血流变化及其相关因素分析  

Changes of blood flow indices of renal artery in patients with primary hypertension and relevant factors

作　　者：郭尚乐 郭端红 GUO Shang-le;GUO Duan-hong(Department of Ultrasound,Datian country hospital,Datian,Fujian,361000,China)

机构地区：[1]福建省大田县总医院超声科,福建三明366100

出　　处：《蛇志》2018年第2期250-252,共3页Journal of Snake

摘　　要：目的观察原发性高血压(PH)患者肾动脉各级血流指标[收缩期峰值流速(PSV)、舒张期末血流速度(EDV)、肾动脉阻力指数(RRI)]变化,并探讨其与临床指标的相关性。方法将180例PH患者分成3组,1级高血压病组54例,2级高血压病组78例,3级高血病组48例,同时选取同期门诊健康体检者60例作为正常对照组,4组均采用彩色多普勒超声检测肾主动脉、肾段动脉、肾叶间动脉PSV、EDV及RRI,全自动生化检测仪检测生化指标,并进行组间比较。结果 (1)与正常对照组比较,1、2、3级的PH患者在TG、LDLC、CREA、UA、CysC、Hcy、SBP、DBP等方面均显著升高,而eGFR水平明显下降(均P<0.01或P<0.05)。(2)与正常对照比较,1、2、3级PH患者各级肾动脉PSV、EDV均明显降低,而RRI明显升高(均P<0.01或P<0.05)。(3)Pearson相关分析,结果显示:PSV、EDV与SBP、DBP、CysC、UA、Hcy、CREA、TG、LDLC均呈明显负相关,与eGFR呈正相关;RRI与SBP、DBP、CysC、UA、Hcy、CREA、TG、LDLC均呈明显正相关,与eGFR呈负相关(均P<0.01或P<0.05)。结论 PH患者各级肾动脉PSV、EDV均明显降低,而RRI明显升高,其可作为评价高血压患者早期肾损害的一个敏感指标。Objective To observe the changes of blood flow indices of renal artery[peak systolic velocity（PSV）,end diastolic velocity（EDV）,renal arterial resistance index（RRI）]in patients with primary hypertension（PH）,and analyze the possible correlations of PSV,EDV,RRI with blood pressure,blood lipids,homocysteine and renal function. Methods There were 180 patients with PH were divided into three group：stage-1 hypertensives group（54 cases）,stage-2 hypertensives group（78 cases）and the stage-3 hypertensives group（48 cases）according to the difference of blood pressure level.At the same time,60 patients with healthy cases were selected as the control group（60 cases）.The PSV,EDV and RRI were measured in main renal artery（MRA）,segmental renal artery（SRA）and interlobar renal artery（IRA）by color Doppler;the biochemical indexes were measured by automatic biochemical analyzer. Results（1）Compared with the control group,the levels of TG,LDLC,CREA,UA,CysC,Hcy,SBP,DBP in the stage-1 hypertensives group,stage-2 hypertensives group and the stage-3 hypertensives group were significantly increased,but the eGFR was significantly decreased（P〈0.05 ORP〈0.01）.（2）Compared with the control group,the PSV and EDV of MRA、SRA and IRA in the stage-1 hypertensives group,stage-2 hypertensives group and the stage-3 hypertensives group were significantly decreased,but the RRI of MRA,SRA and IRA in the stage-1 hypertensives group,stage-2 hypertensives group and the stage-3 hypertensives group were significantly increased（P〈0.05 ORP〈0.01）.（3）Pearson correlation analysis revealed that Both the PSV and EDV were negatively correlated with the SBP,DBP,CysC,UA,Hcy,CREA,TG,LDLC,but was positively correlated with the eGFR（P〈0.05 OR P〈0.01）;RRI was positively correlated with the SBP,DBP,CysC,UA,Hcy,CREA,TG,LDLC,but was negatively correlated with the eGFR（P〈0.05 ORP〈0.01）. Conclusion The PSV and EDV of MRA,SRA and IRA in the PH were significantly decreased,but the RRI of MRA,SR

关 键 词：原发性高血压 肾动脉 收缩期峰值流速 舒张期末血流速度 肾动脉阻力指数 相关性 

分 类 号：R544.1[医药卫生—心血管疾病]