老年高血压患者大动脉弹性研究  

Clinical study of large artery distensibility in elderly hypertensive patients

作　　者：王宏宇[1] 倪永斌[1] 龚兰生[2] 张维忠[2] 胡大一[1] 

机构地区：[1]北京大学人民医院心脏内科,北京100044 [2]上海第二医科大学附属瑞金医院

出　　处：《中国老年学杂志》2003年第1期10-12,共3页Chinese Journal of Gerontology

摘　　要：目的　比较老年高血压患者和非老年高血压患者大动脉扩张性的改变程度 ,为临床选择敏感反映老年高血压患者大动脉损害和预后危险的指标。方法　选择原发性高血压患者和老年高血压患者 ,应用自动脉搏波速度 (PWV)测定仪测定颈动脉 -股动脉 PWV作为反映大动脉节段扩张性的参数 ;应用 B型超声对颈动脉进行扫查。比较两组间颈动脉 -股动脉 PWV值、颈总动脉腔径、横断面顺应性、容积扩张性的变化。多因素分析用于筛选敏感反映 PWV改变的因素。结果　脉压水平、PWV、颈总动脉收缩期内径在老年高血压组明显增高 ((P=0 .0 0 5 3,P=0 .0 0 0 1 ,P=0 .0 30 0 ) ;颈总动脉横断面顺应性、容积扩张性在两组间无显著性差异 (P=0 .81 3 8,P=0 .855 0 ) ;多因素分析结果表明年龄、收缩压是与 PWV关系最为密切的因素。结论　高血压导致大动脉损害 ;PWV能敏感反映大动脉扩张性的变化 ;年龄和收缩压是影响 PWV的两个主要因素 ;PWV测定为临床提供了一种重要的无创、简便、可动态评估老年高血压患者大动脉损害和预后危险程度的方法。Objective To Compare large arterial distensibility between elderly hypertensive patients and non-elderly hypertensive patients; Select sensitive index to reflect large artery damage in elderly hypertensive patients. Methods Automatic pulse wave velocity (PWV) analysis system was applied to examine 130 hypertensive patients, 88 men,42 women, mean age 54.95±10.59 years. Among them 49 were elderly patients (age≥60 years). Carotid-femoral PWV acted as a parameter to reflect large artery distensibility. B-mode ultrasound was used to detect carotid artery. Common carotid artery diameter, common carotid artery cross-sectional compliance (CSC), common carotid artery volumic distensibility(VD) were measured. Multiple factors analysis was used to select sensitive factors that reflect the change of PWV. Results Pulse pressure, PWV, and common carotid artery systolic diameter were higher in elderly hypertensive patients (P=0.005 3, P=0.000 1,P=0.030 0, respectively); Common carotid artery CSC and common carotid artery VD had no significant difference between elderly hypertensive patients and non-elderly hypertensive patients (P=0.813 8,P=0.855 0,respectively); Multiple factors analysis demonstrated that age (r=0.462 8,P= 0.000 1) and systolic blood pressure (r=0.309 1,P=0.000 7) were parameters that had close relationship with PWV. Conclusions Hypertension could induce damage of large artery distensibility, particularly in elderly patients. Age and systolic blood pressure had close relationship with PWV.PWV could sensitive reflect change of large artery distensibility, it could be used as an important no-invasive, simple, repetitive measurement index to evaluate large artery damage and prognostic risk of elderly hypertensive patients.

关 键 词：高血压 大动脉弹性 脉搏波传导速度 老年人 预后 

分 类 号：R544.1[医药卫生—心血管疾病]