降压治疗对颈动脉内膜中层厚度和动脉顺应性影响的研究  

The effect of antihypertensive therapy on intima-media thickness of the common carotid artery and vascular compliance

作　　者：李新立[1] 蒋素华[1] 张海峰[1] 倪春辉[1] 雍永宏[1] 王震震[1] 黄峻[1] 

机构地区：[1]南京医科大学第一附属医院心内科,210029

出　　处：《中华心血管病杂志》2003年第4期254-256,共3页Chinese Journal of Cardiology

基　　金：江苏省自然科学基金项目 (BK2 0 0 2 0 2 9)

摘　　要：目的　探讨降压治疗对颈动脉内膜中层厚度 (IMT)和动脉顺应性影响的关系及其临床意义。方法　分别选取正常对照组 45例、高血压控制组 35例和高血压未控制组 36例 ,使用美国产CVProfilorDO 2 0 2 0动脉测试仪同步记录血压和动脉顺应性 [大动脉弹性 (C1 ) ,小动脉弹性 (C2 ) ],美国产HP5 5 0 0超声多普勒高分辨率 7 5MHz扫描探头测量颈动脉IMT和血管内径变化。结果　高血压未控制组颈动脉IMT明显增厚 ,与高血压控制组和正常对照组比较有显著性差异 (P <0 0 5 ) ,后二组间无统计学意义 (P >0 0 5 )。颈动脉内径在高血压未控制组与对照组间有显著性差异 (P <0 0 1) ,高血压未控制组与控制组间无显著性差异 (P >0 0 5 ) ,三组间收缩压 (SBP)、舒张压 (DBP)和脉压 (PP)比较均有显著性差异 (P <0 0 1) ,高血压未控制组C1 和C2 均低于对照组和高血压控制组 (P <0 0 1) ,后二组间无显著性差异 (P >0 0 5 )。三组的SBP、PP均与C1 呈负相关 (r= 0 314,P <0 0 5 ;r = 0 4 82 ,P <0 0 1;r = 0 342 ,P <0 0 5 ;r= 0 384,P <0 0 5 ;r = 0 315 ,P <0 0 5 ;r = 0 36 5 ,P <0 0 5 )。对照组颈动脉IMT与C1 呈负相关 (r = 0 36 9,P <0 0 1) ;对照组和高血压控制组的颈动脉IMT与C2 呈负相关 (r= 0 4Objective To investigate the effect of antihypertensive therapy on intima-media thickness(IMT) of the common carotid artery(CCA) and vascular compliance. Methods 116 subjects were divided into three groups,45 normotensive individuals as the control group,35 subjects in controlled hypertension group,and 36 patients in uncontrolled hypertension group.Blood pressure and artery compliance(C 1-large artery,C 2-small artery) were detected using HDI DO-2020.IMT of CCA was measured using HP5500 ultrasound with a high-resolution (7.5MHz) scaning head. Results IMT of the CCA of essential hypertension(EH)-uncontrolled group was markedly increased,compared with between control group and EH-controlled group(P<0.01),but there was no statistical difference between control and EH-controlled groups(P>0.05).Lumen diameter(LD) of CCA between control and EH-uncontrolled groups differed markedly(P<0.01),but there was no difference between EH-controlled and EH-uncontrolled groups(P>0.05).Systolic(SBP),diastolic(DBP) and pule pressure( PP) among three groups were significantly different groups (P<0.01).Both C 1 and C 2 in EH-uncontrolled group were lower than those in control group and EH-controlled groups (P<0.01). C 1 among three groups was negatively associated with SBP and PP.In control group, C 1 was only negatively associated with IMT of CCA. C 2 in both control and EH-controlled groups was reversely associated with IMT of CCA . C 2 of EH-controlled and EH-uncontrolled groups was negatively associated with SBP and PP. There was no correlation between C 2 and DBP among three groups. Conclusion Antihypertensive therapy can cause regression of structural changes in the CCA in hypertensive patients. The correlation of vascular compliance(C 1,C 2) with SBP and PP was better than that with IMT of CCA.

关 键 词：高血压 颈动脉内膜中层厚度 动脉顺应性 降压药 临床意义 

分 类 号：R54[医药卫生—心血管疾病]