老年高血压患者下肢动脉病变与动脉硬化指标的相关性研究

目的 探讨老年高血压患者下肢动脉病变与动脉硬化指标的相关性,为早期防治下肢动脉粥样硬化提供临床依据.方法 88例老年高血压患者进行彩色多普勒超声检查和无创性动脉硬化监测,分别按脉搏波传导速度（baPWV）和踝臂指数分为2组：baPWV增高组（baPWV大于年龄、性别-baPWV标准曲线）和baPWV正常组（baPWV小于年龄、性别-baPWV标准曲线）,踝臂指数低值组（踝臂指数≤0.9）和踝臂指数正常组（踝臂指数＞0.9）,对2组患者的血管内径,内-中膜厚度（IMT）、收缩期峰值血流速度（pSV）、舒张期末血流速度（EDV）、搏动指数、阻力指数等进行分析.结果 与baPWV正常组相比,baPWV增高组IMT明显增厚股动脉（1.08±0.16）mm比（0.93±0.13）mm,P＜0.01];胭动脉（1.02±0.16）mm比（90.84 ±0.11）mm,P ＜0.01]、PSV股动脉（75±16） cm/s比（68±13） cm/s,P＜0.05];胭动脉（50±7）mm比（56±11）mm,P＜0.01]、EDV股动脉（12.5±2.0）cm/s比（19.6±2.4） cm/s,P＜0.01];胭动脉（10.1±2.0）mm比（14.9±2.7）mm,P＜0.01]和搏动指数（股动脉2.3±1.3比3.6±1.5,P＜0.01;胭动脉4.0±1.9比4.9±2.0,P ＜0.05）明显减低而阻力指数明显增大（股动脉0.82±0.23比0.73±0.18,P＜0.05;胭动脉0.82±0.22比0.73 ±0.20,P＜0.05）,差异均有统计学意义.与baPWV正常组相比,baPWV增高组下肢动脉狭窄的发生率更高91.3％ （42/46）比76.2％（32/42）,P＜0.01],狭窄程度更重.同样,与踝臂指数正常组相比,踝臂指数低值组IMT明显增厚股动脉（1.12±0.18） mm比（0.88 ±0.12） mm,P＜0.01];胭动脉（1.10±0.17）mm比（0.80 ±0.15）mm,P＜0.01]、PSV股动脉（58±12） cm/s比（80±16） cm/s,P＜0.01];胭动脉（46 ±6）mm比（60±14）mm,P＜0.01]、EDV股动脉（10.1±1.9） cm/s比（23.3 ±3.2）cm/s,P＜0.01];胭动脉（9.1±2.1）mm比（16.2±3.2）mm,P＜0.01]、搏动指数股动脉2.2±1.3比3.7±1.7,P＜0.01];胭动脉3.9±2.0比5.0±2.

Correlation between atheroscleros is markers and lower limb arterial diseases in elderly patients with hypertension

Objective To investigate the correlation between arteriosclerosis markers and lower limb arterial diseases in elderly patients with hypertension; to provide clinical evidence for early prevention of lower limb atherosclerosis.Methods Color Doppler ultrasonography and noninvasive assessment of arteriosclerosis were measured in 88 elderly patients with hypertension.According to pulse wave velocity （baPWV） or ankle-brachial index （ABI）,the patients were divided to two groups：high baPWV group （baPWV was higher than age and gender-baPWV standard curve）,normal baPWV group （baPWY was lower than age and gender-baPWV standard curve）,low ABI group （ABI ≤0.9） and normal ABI group （ABI 〉 0.9）.Results Compared to that in normal baPWV group,interior-medial thickness （IMT） was significantly thicker femoral artery（1.08 ±0.16）mm vs.（0.93±0.13） mm,P〈0.01]; popliteal artery（1.02±0.16）mm vs.（0.84±0.11）mm,P〈0.01],peak systolic velocity （PSV） femoral artery （68 ± 13）cm/s vs.（75 ± 16） em/s,P 〈0.05] ;popliteal artery （50 ± 70） cm/s vs （56 ± 11） cm/s,P 〈 0.01],end diastolic velocity （EDV） femoral artery （12.5 ± 2.0） cm/s vs.（19.6±2.4） cm/s,P〈0.01]; poplitealartery（10.1±2.0） cm/s vs.（14.9 ±2.7） cm/s,P〈0.01） and pulsatility index （PI） （femoral artery,（2.3 ± 1.3） vs （3.6 ± 1.5）,P 〈 0.01 ; popliteal artery,（4.0 ± 1.9） vs （4.9 ± 2.0）,P 〈 0.05）] were significantly lower,but resistant index （RI） femoral artery,（0.82 ± 0.23） vs （0.73 ± 0.18）,P 〈 0.05 ; popliteal artery,（0.82 ± 0.22） vs （0.73 ± 0.20）,P 〈 0.05] was significantly higher in the high baPWV group.There was a higher morbidity of lower limb arterial stenosis and more stenosis in high baPWV group than that in normal baPWV group91.3% （42/46） vs 76.2% （32/42）,P 〈0.01].Similarly,compared with that in normal ABI group,IMT was significantly thicker femoral artery,（1.12 ±0.18） mm vs （0.88±0.12）