杓型和非杓型高血压病患者动脉重构的改变

目的通过比较杓型与非杓型原发性高血压患者动脉重构的参数变化，探讨原发性高血压患者血压节律类型与动脉重构的相关性。方法选取1、2级原发性高血压患者128例，行动态血压监测，根据夜间平均动脉压下降10％以上或以下的标准分为杓型组（56例）与非杓型组（72例），应用彩色多普勒超声检测颈总动脉内膜中层厚度（IMT）、脉搏波速度测定仪同时检测颈动脉-桡动脉（C-RPWV）、颈动脉-股动脉（C-FPWV）的脉搏波速度，测定血清中内皮素1（ET-1）和一氧化氮（N0）浓度。比较两组间上述检测指标。结果非杓型组IMT较杓型组明显增厚；C-RPWV和C-FPWV在非杓型组明显高于杓型组；血清ET-1浓度在非杓型组明显高于杓型组，而NO浓度低于杓型组，两因子在两组间比较具有统计学差异。结论非杓型血压较杓型血压对动脉结构及功能的影响可能更明显。

Changes of arterial remodeling in dipper and non-dipper essential hypertension patients:analysis of 128 cases

Objective To investigate the correlation between arterial remodeling and different circadian blood pressure rhythms in patients with essential hypertension by comparing parameters of the arterial remodeling between the dipper and non-dipper hypertensive patients. Methods According to ambulatory blood pressure,128 patients with essential hypertension were divided into dipper group(n=56) and non-dipper group(n=72). Intima-media thickness(IMT) of carotid artery were examined by echocardiography. Automatic pulse wave velocity (PWV) measuring system was used to examine carotid-femoral PWV and carotid-radial PWV. The concentrations of serum endothelin 1(ET-1) and nitrogen monoxide (NO)were measured. Then the afore mentioned indexes were compared between the dipper and non-dipper hypertensive groups. Results Compared with dipper group,non-dipper group presented increased IMT,PWV and the concentrations of serum ET-1 and decreased NO. Conclusion The non-dipper hypertension exerts more significant influence on arterial structure and function than the dipper hypertension does.