从高血压到脑卒中的脑血管血流动力学指标变化规律

目的:探讨从高血压到脑卒中的脑血管血流动力学指标(cerebralvascu-larhemodynmic,CVHD)的变化规律。方法:队列人群中随访发生的371例有高血压病史的脑卒中患者按年龄、性别随机选择其它组别,分成血压正常组、临界高血压组、高血压组、脑卒中前高血压组和脑卒中后遗症组。分析和观察CVHD的分布和变化规律。结果:5组人群的CVHD积分中位数分别为95.5,90.0,78.75,40.0和51.25分,其中<75分的百分率分别为19.9%,36.8%,46.3%,78.7%和69.5%;从血压正常到脑卒中发病前,脑血管血流速度呈明显的降低趋势,外周阻力和特性阻抗等动力学指标呈明显的升高趋势。结论:随着高血压的发生和发展,脑血管功能异常逐渐加重,当总积分值下降至40分左右,为脑卒中发病前的“超高危”状态,是脑卒中发生的重要预警信号。

The variational trends of cerebral vascular hemodynamic indexes from hypertension to stroke

AIM:To investigate various trends of cerebral vascular hemodynamic(CVHD)indexes from hypertension to stroke.METHODS :371stroke pa-tients with history of hypertension in a cohort population were selected and other groups was randomly selected f rom the cohort according to age and se x.The participants were defined as 5groups,such as normal tension,critic al hypertension,hypertension,pre-s troke hypertension and stroke conva les-cence group.Differences of CVHD accumulative scores and other indexes between groups were compared,and tr ends of variance from hypertension t o stroke were observed.RESULTS:Median of CVHD scores from normal tension to stroke were 95.5,90.0,78.75,40.0and 51.25,respectively(P<0.01).Rate of CVHD scores under 75points were 19.9%?36.8%?46.3%?78.7%and 69.5%,respectively(P<0.01).From normal ten-sion to predicament before stroke,V max ,Vmin and Vmean were significantly decreased.However,indexes such as RV,Zcv,WV,DR and Cp appeared adverse trends.CONCLUSION:The trends of CVHD indexes abnormal ity were significant from normal pressu re to hypertension as well as pre-str oke status.It seems go beyond high risk s tatus and was an important risk signal of stroke when the CVHD score drop to 40points about.