原发性高血压患者无创检测大动脉重构的临床意义

目的 :研究原发性高血压 (EH)对大动脉结构和功能的影响 ,选择能反映EH患者预后的敏感指标。方法 :对 6 4例EH患者和 36例正常人在二维超声下分别检测主动脉及股动脉内膜、收缩期及舒张期内径 ,并计算血管壁 /腔径比、血管壁 /腔径面积比等反映血管结构改变的指标 ,并利用彩色多普勒超声仪测量主 股动脉脉搏波速度 ,并计算动脉扩张性和顺应性等反映动脉功能的指标。结果 :反映血管结构的内膜中层厚度、血管腔径、血管腔径面积及血管壁 /腔径比及血管壁 /腔径面积比 ,EH组显著高于正常组 ,而反映大动脉缓冲功能的主动脉 股动脉脉搏波速度EH组也显著高于正常组 ,甚至在校正了年龄、性别、体重指数、心率、吸烟等影响因素后 ,差异依然存在。结论 :高血压所致大动脉重构表现为动脉结构和功能的改变 ,早期发现这些改变对预防和治疗高血压有积极的作用 ,而主动脉 股动脉脉搏波速度可以较早并准确的反映大动脉功能的减退 ,为临床提供了一个重要的无创性指标

Clinical significance of non-invasive evaluation of large-artery remodeling in hypertensive patients

Objective:To investigate the influence of large arterial structure and function changes in patients with essential hypertension and to select the sensitive indicators for predicting their prognosis. Methods:Sixty four essential hypertensive patients and 36 normotensive subjects were selecfed and two demensional echocardiography, were used to examine their aortic and femoral structure changes including intima-media thickness (IMT) and the internal diametel during systole and diastole(DS 1 DD), wall thickness/diameter of lnmina(T/D). wall thickness/area of lumina(T/DS), luminal cross section area(LSA); and the aorta femoral artery pulse ware velocity(A FPWV) and their lafeneibility and compliance were meas ured by color doppler echocardiography to test their functional changes.Results:Compared with normotensive subjects, hypertensive patients presented increased IMT, DS, DD, LSA, T/D, Ts/D, A FPWV, even after adjusted for the confounding factors (including sex, age, heart rate, body mass index, smoke, and so on). Conclusion: Large artery remodeling has been found in patients with essential hypertension in early stage. Determining these changes can play an important role in treatment and prevention of hypertensive. As a significant and non invasive indicator, arotic PWV in early stage can reflect large arterial functional damage accurately and will be employed widely.