原发性高血压患者颈动脉内-中膜厚度及粥样斑块的特点及临床分析

目的　探讨原发性高血压患者颈总动脉内 -中膜厚度及颈动脉的斑块的特点及其与危险因素之间的关系。方法　原发性高血压患者 5 4例 ,分作无器官损害组 (A组 ) 38例及合并器官损害组 (B组 ) 16例 ,另设正常对照组 (C组 ) 18例 ,超声波检测颈总动脉内 中膜厚度 (intima mediathickness,IMT)及颈内、颈外动脉与颈总动脉分叉处斑块情况 ,并测定血总胆固醇、甘油三酯、低密度脂蛋白胆固醇及高密度脂蛋白胆固醇、血糖等指标。结果　A组及B组的颈总动脉内 中膜厚度显著大于C组 [C组 (0 . 4 5± 0 . 16 )mm ,A组 (0 . 6 7± 0 .2 0 )mm ,B组 (0 . 94± 0 . 2 8)mm ,三组之间两两比较差异均有统计学意义 ,P <0 . 0 1];B组的IMT显著大于A组 ;三组间颈动脉斑块严重程度差异有统计学意义 (χ2 =2 1 78,P <0 . 0 1) ;患者IMT值与颈动脉斑块严重程度呈正相关 (r =0 6 2 ,P <0 . 0 1) ,与颈动脉的斑块数呈正相关 (r =0 . 5 1,P <0 . 0 1) ;多元线性回归分析示 ,高血压患者的IMT与年龄及原发性高血压年数相关性较强 (r =0 .6 17,F =12 . 32 ,P <0 . 0 1)。结论　高血压可使颈总动脉内 -中膜厚度 (IMT)增加 ,从而引起动脉粥样硬化 ,而且损害随原发性高血压病程增加而加重 ;超声检测可作为一种简便的手段早期检测到动?

Structural change of common carotid artery in patients with hypertension

Objective The intima-media thickness (IMT) of common carotid artery (CCA) correlated with atherosclerosis and coronary heart disease.This study was designed to investigate the relationship of CCA IMT and carotid plaque with hypertension conditions as a risk factor.Methods Carotid ultrasound examination was performed to compare the IMT and atherosclerotic plaques in 54 hypertension patients with those in 18 controls.Fifty-four patients with hypertension were divided into two groups;group B was with and group A without complications such as coronary heart disease and stroke. Results The IMT of controls,Group A,and Group B was (0.45±0.19)mm,(0.67±0.20)mm and (0.94±0.28)mm,respectively,(P<0.01).The scores of atherosclerosis for hypertension patients were more than those for controls (χ2=21.78,P<0.01).The scores of atherosclerosis (r=0.62,P<0.01) and numbers of plaques (r=0.51,P<0.01)were positively related to IMT.Upon multivariate analyses the IMT of CCA was significantly related to age and duration of hypertension (r=0.617,F=12.32,P<0.01).Conclusion Hypertension might impair intima of the artery,and this process could be promoted with the aggravation of hypertension.Carotid ultrasound examination could be used to evaluate atherosclerosis and impairment of artery.The IMT of CCA correlated with the age of patients significantly.