Comparison of invasive dynamic blood pressure between superior mesenteric artery and common carotid artery in rats

The purpose of this study was to identify the consistency of invasive dynamic blood pressure (BP) monitoring between the superior mesenteric artery (SMA) and the common carotid artery (CCA). METHODS: Eight male Sprague-Dawley rats were cannulated in SMA and CCA simultaneously for BP monitoring, respectively. The abdominal aorta was prepared for the induction of BP change through clamping/de-clamping by a microvascular clip. The dynamic BP monitoring was performed by a polygraph system. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) values would be recorded during different time periods: the baseline (T1), the increasing period after clamping (T2), the platform period during clamping (T3), the decreasing period after de-clamping (T4), and the final platform period (T5). Three trials were performed on each rat with 15-minute intervals between consecutive monitoring. RESULTS: Systolic BP showed no significant differences between SMA and CCA. However, significant difference was found in diastolic blood pressure except at T5 (P=0.534). Mean arterial pressure of two arteries were signi cantly different only at T1 (P=0.015). The strength of association was significantly high between BP measurements through SMA and CCA (P<0.001). The Bland- Altman analyses showed that mean bias of MAP changed no more than 5 mmHg and standard deviation less than 8 mmHg during T2 and T4, respectively. CONCLUSION: The study indicates SMA might be an alternative site for invasive BP monitoring during abdominal aorta occlusion and release, especially in cerebrovascular-related research.     

血压变异与颈动脉粥样硬化的关系

目的探讨原发性高血压(EH)患者血压变异(BPV)与颈动脉硬化(CAS)的关系。方法 114例EH患者根据颈动脉超声检查结果分为CAS组66例和非CAS组48例,比较两组患者性别、年龄、吸烟、空腹血糖(FBG)、血脂、血肌酐(Cr)、血尿酸(UA)、血压及BPV的差异,并对CAS相关危险因素进行Logistic回归分析。结果 CAS组患者性别、年龄、吸烟、TC、LDL-C、24 h平均收缩压(24 h SBP)、24 h收缩压标准差(24 h SSD)、24 h舒张压标准差(24 h DSD)均高于非CAS组(P<0.01),HDL-C低于非CAS组(P<0.01),Logistic回归分析显示年龄、吸烟、TC、HDL-C、24 h SBP及24 h SSD均是CAS主要危险因素(P<0.05)。结论 EH患者BPV与CAS密切相关,降低BPV对减少高血压靶器官损害具有重要意义。     

甲状腺上动脉峰值流速与Graves病患者甲状腺激素水平及术中出血量关系的研究

目的研究甲状腺上动脉峰值流速(STA-PSV)与Graves病患者甲状腺激素水平及甲状腺切除术中失血量的关系。方法选取2010年1月到2013年12月确诊并且将实施甲状腺切除术的Graves病患者110例。根据超声检测STA-PSV值将患者分为三组:50 cm/s组、50~100 cm/s组以及100 cm/s组。术前测定各组患者的血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)水平,记录患者术前服用抗甲状腺药物时间、术中出血情况和术后并发症,并进行统计学分析。结果随着患者的STA-PSV的增加,FT3、FT4和TSH也升高,而抗甲状腺药物使用时间减少,术中出血量增多,术后并发症发生率增加(P0.05)。结论 Graves病患者的STA-PSV与甲状腺激素水平、手术失血量以及术后并发症发生率呈正相关。建议将STA-PSV作为甲状腺手术术前评估的常用指标。     

糖尿病患者视网膜中央动脉血流动力学的研究

目的探讨糖尿病患者视网膜中央动脉的血流动力学变化规律。方法用彩色多普勒超声检测66例糖尿病患者和30例正常对照者的视网膜中央动脉收缩期最高血流速度(Vmax)、舒张末期最低血流速度(Vmin)、阻力指数(RI)、搏动指数(PI);用免疫凝集抑制法测定全部病人的糖化血红蛋白。结果糖尿病患者视网膜中央动脉的Vmax,Vmin均低于正常组(p<0.05),RI高于正常组(p<0.05)。糖化血红蛋白与糖尿病患者视网膜中央动脉的血流速度呈负相关,与RI呈正相关。结论糖尿病患者存在视网膜中央动脉血流动力学异常,且发生在视网膜血管形态学改变之前,与血糖水平有关。     

原发性高血压患者左心室舒张早期血流传播速度的变化及其临床意义

目的探讨原发性高血压患者左心室舒张早期血流传播速度(VP)变化与左心室几何构型改变之间的关系.方法对原发性高血压患者105例和健康志愿者37例,应用M型超声心动图测量左心室舒张末期内径(LVIDd)、室间隔舒张末期厚度(IVSd)、左心室后壁舒张末期厚度(LVPWd)和左心室射血分数(LVEF),并计算左心室相对室壁厚度(RWT)及左心室心肌质量指数(LVMI),采用彩色M型多普勒在心尖四腔心切面测量VP,并对超声参数行组间分析比较.结果根据LVMI和RWT的不同,将高血压患者分为左心室正常构型(35例)、向心性重构型(22例)、向心性肥厚型(28例)和离心性肥厚型(20例),高血压各组VP均较对照组减小(P＜0.05或0.01),且在正常构型、向心性重构、向心性肥厚和离心性肥厚组呈逐渐减小趋势(P＜0.05或0.01).Spearman等级相关分析显示VP与左心室几何构型变化之间存在良好相关性(r=-0.62,P＜0.01).多元线性回归分析显示,LVMI、收缩压和年龄是高血压患者VP的重要影响因素(分别r=-0.40,P=0.02;r=-0.25,P=0.04;r=-0.20,P=0.01).结论VP在原发性高血压患者均小于正常对照组,且在正常构型、向心性重构、向心性肥厚和离心性肥厚组呈依次递减趋势,准确反映了高血压左心室重构过程中舒张功能受损程度的变化.     

肝硬化并发肝癌病例中的肝动脉峰值流速与阻力指数的动态变化

目的探讨超声检测肝动脉血流峰速度(Vmax)与阻力指数(RI)的动态变化早期诊断结节性肝癌(肿块的直径在1cm以下)的临床应用价值;方法选取临床诊断为肝硬化的乙肝患者150例,应用超声定期检查肝动脉的Vmax、RI,直至患者被影像检查及临床诊断为结节性肝癌,计算Vmax、RI的动态变化值⊿Vmax、⊿RI,进而计算⊿Vmax、⊿RI动态变化的百分比;结果从肝硬化发展为结节性肝癌的23例患者的肝动脉Vmax、RI初检至癌变前无明显变化(P>0.05),出现结节性肝癌时飞跃性增加或降低(P<0.05),且⊿Vmax%、⊿RI%的95%参考值范围与癌变前的测值范围无重叠;结论肝动脉Vmax、RI等血流参数的动态变化是早期诊断结节性肝癌的可靠参数。     

The effects of regular consumption of green or black tea beverage on blood pressure in those with elevated blood pressure or hypertension: A systematic review and meta-analysis

ObjectiveAs a popular beverage, there has been much interest in studying the effects of tea intake on hypertension (HTN), a particular risk factor for cardiovascular disorders (CVDs). We have thus aimed to isolate the randomized controlled trials investigating the efficacy of black or green tea as a beverage in subjects with elevated blood pressure (BP), or HTN.MethodsPubMed, Scopus, Web of Science, and ProQuest dissertations and theses databases were searched from February 1, 1995, up to July 20, 2019, to identify relevant studies.ResultsThe search strategy generated 1119 trials, of which finally five trials fulfilled the criteria for being included in the current study. Three out of 5 articles showed a low risk of bias. According to nine measurements derived from 5 trials on 408 individuals, it was found that regular tea intake resulted in the reduction in SBP (weighted mean difference (WMD): −4.81 mmHg, 95 %CI: −8.40 to −1.58, P = .004) and DBP (WMD:-1.98 mmHg, 95 %CI: −3.77 to −0.20, P = .029); however, excluding the most heterogeneous trials showed that regular tea intake might reduce SBP and DBP by about −3.53 and −0.99 mmHg, respectively. Based on meta-regression findings, we found the longer the duration of tea intake (≥3months), the higher the decrease in both SBP and DBP. Categorized studies, according to the tea type, revealed that the hypotensive effects of green tea were more pronounced compared to black tea. None of the studies reported any side effects.ConclusionThese results suggest the positive effects of regular tea intake on BP in subjects with elevated BP or HTN. Hence, it may be applicable to physicians, health care providers, and particularly HTN patients.     

健康老年人米餐后脑血流速度及血压心率的变化

目的　研究健康老年人米餐后脑血流速度及血压、心率变化规律。方法　测定 30例健康老人[平均年龄 (70± 3)岁 ]米餐前后脑血流速度 (CFV)、血压及心率变化指标。结果　米餐后脑血流速度较米餐前显著减慢 (P <0 0 1) ,动脉血压略有下降 ,心率略快 (P >0 0 5 )。结论　米餐 30min后老年人脑血管收缩期和部分脑血管舒张期血流量减少 ,心率及血压无明显变化。     

彩色多普勒血流显像对视网膜中央动脉栓塞眼血流动力学的研究

我们利用彩色多普勒血流显像（ＣＤＦＩ）技术。对１５例（１５只病眼，１５只健眼）视网膜中央动脉（ＣＲＡ）栓塞者与３０例正常人（６Ｏ只眼）的ＣＲＡ血流参数及睫状动脉（ＣＡ）、眼动脉（ＯＡ）及颈内动脉（ＩＣＡ）的ＣＤＦＩ显示情况的研究。正常人ＣＲＡ血流检出率１００％，栓塞组：ＣＲＡ显示差者１２例占８０％，未检出者３例占２０％。合并ＩＣＡ硬化ＩＣＡ狭窄或阻塞者５例占３３％。正常人与ＣＲＡ栓塞及其健眼与患侧眼ＣＲＡ血流参数比较结果，除ＲＩ：Ｐ＞０．０５外，余Ｐ＜０．０ｌ。描述了正常ＣＲＡ及ＣＲＡ栓塞的ＣＤＦＩ及血流频谱的特点。讨论了不同原因所致的栓塞的超声表现；ＣＤＦＩ在检测ＣＲＡ中的优越性，指出彩色血流可作为估计内径的参考值。动脉硬化是本病的最主要的致病因素之一，并认为ＣＤＮ对ＣＲＡ栓塞能检出病变、部位、程度，结合临床分析病因，可为临床提供有力的诊断和治疗依据。     

血压变异性研究进展

血压变异性（BPV）是描述血压在一段时间内波动程度的量化指标,按照评价时间的长短分为短时血压变异和长时血压变异,各自受到不同因素的影响。获取血压变异信息的方式也不尽相同,24小时无创动态血压监测、家庭自测血压和长期诊室随访血压测定是常用的方法。临床研究显示,高血压患者的长时血压变异大小主要与患者的动脉血管结构与功能有关,且血压变异增大与卒中等心血管终点事件相关。近年来,有关BPV的研究受到重视,BPV的临床意义及应用、与高血压患者靶器官损害和预后的关系合理的临床评价指标等热点问题尚存争议。     

Intermittent drop in blood flow velocity in the internal carotid artery and its branches

Extracranial Doppler sonography and transcranial Doppler sonography (TCD) allow the assessment and monitoring of hemodynamic and embolic events in cerebrovascular diseases. We describe an unusual hemodynamic phenomenon in a patient with intracranial carotid siphon stenosis and no clinical symptoms of stenosis. TCD examination suggested and angiography confirmed stenosis of the left internal carotid artery siphon. TCD examination revealed a sudden, intermittent drop in blood flow velocity in both the prestenotic and poststenotic segments of the internal carotid artery, whereas cardiac hemodynamic parameters were unaffected. Embolic signals were detected in the poststenotic vessels only. We speculate that such sonographic findings may be caused by intermittent vessel occlusions due to the reversible displacement of an intraluminal thrombus in relation to the cardiac cycle.     

高血压病脉压与相对脉搏波速度关系的研究

目的　应用多普勒组织显像(DTI)技术研究原发性高血压患者脉压与主动脉相对脉搏波速度的关系。方法　对91例原发性高血压患者的腹主动脉前壁(AAo)进行PW DTI检查,结合同步心电图描记,测量电机械时间(EMT)、左室射血前期时间(PEP)、脉搏波时间(PWT,PWT=EMT-PEP);同时测量患者身高(H),计算相对脉搏波速度(RPWV,RPWV=H/PWT)。结果　脉压≥60mmHg(1mmHg=0. 133kPa)者的RPWV显著高于脉压<60mmHg者[ (162. 03±27. 87 )m/s和(75. 37±18. 74)m/s, P<0. 001]。RPWV与脉压和年龄显著正相关(脉压r=0. 536,P=0. 000;年龄r=0. 335,P=0. 003)。结论　RPWV与脉压密切相关,可作为一项新的评价动脉硬度的指标应用于高血压病的相关研究。     

阻塞性睡眠呼吸暂停综合征伴血压升高患者血压、血糖及血脂控制情况

目的调查阻塞性睡眠呼吸暂停综合征(OSAS)伴血压升高患者在不同状态下血压、血糖、血脂控制情况。方法对57例OSAS合并高血压或正常高值患者的血压、血糖、血脂控制水平进行调查和随访,并与患者住院时的血压、血糖、血脂数值进行比较分析。同时对行腭咽成形术治疗的高血压患者手术前后的血压控制情况进行分析。结果 (1)高血压组调查时收缩压(SBP),舒张压(DBP)与住院时SBP及DBP相比明显降低(P<0.05);空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)调查时与住院时相比无差异(P>0.05)。(2)正常高值组调查时SBP、DBP、FBG、TC均较住院时增高(P<0.05);调查时TG与住院时相比无差异(P>0.05)。(3)合并高血压且行OSAS手术治疗的患者手术后SBP、DBP与手术前SBP、DBP比较明显降低(P<0.05)。结论 OSAS合并高血压患者出院后血压得到控制,但血糖和血脂有增高趋势;血压正常高值患者出院后血压、血糖、血脂均有增高趋势;OSAS伴高血压患者手术后血压水平得到改善。     

高血压合并慢性肾脏病患者的动态血压分析

目的 探讨原发性高血压合并慢性肾功能不全后动态血压的变化特点.方法 对28例单纯原发性高血压患者(A组)和25例合并慢性肾脏功能不全的高血压患者(B组)进行动态血压监测.结果 ①血压比较:24 h舒张压B组高于A组[(80.9±13.4)mm Hg比(70.3±15.6)mm Hg,P＜0.05)];B组夜间的收缩压与舒张压均高于A组[(160.2±17.8)mm Hg比(140.3±25.9)mm Hg和(82.6±16.1)姗Hg比(68.8±20.2)mm Hg,P＜0.01].②血压变异性比较:B组24 h收缩压变异性和舒张压变异性均高于A组[(13.5±3.9)mm Hg比(11.3±2.1)mm Hg和(9.2±1.2)mm Hg比(8.3±1.8)mm Hg,P＜0.05],B组夜间的收缩压与舒张压变异性均高于A组[(14.9±3.3)mm Hg比(9.3±2.1)mm Hg和(9.7±2.4)mm Hg比(8.0±2.2)mm Hg,P＜0.01)].③血压趋势比较:A组血压趋势以非勺型为多,占64.3%(18/28),反勺型占10.7%(3/28);而B组反勺型占48.0%(12/25),非勺型占40.0%(10/25).结论 肾性因素参与的高血压患者血压趋势紊乱,夜间血压及变异性明显增加,均可成为肾功能继续恶化和心脑血管事件发生的重要因素.     

Reduced flow velocity in the internal carotid artery independently of cardiac hemodynamics in patients with cerebral ischemia

PURPOSE: To retrospectively investigate the relationships between carotid flow velocities, clinical features and cardiac hemodynamics to assess the meaning and significance of reduced carotid flow velocities in patients with cerebral ischemic symptoms. METHODS: We selected the files from patients who had undergone duplex Doppler sonographic examination of extracranial carotid arteries, echocardiography, and MR angiography, and in whom the following parameters were available: peak systolic (PSV) and end diastolic (EDV) flow velocity, pulsatility index (PI), and diameter of the left and right common (CCA) and internal (ICA) carotid arteries, intima-media thickness (IMT) of the left and right CCA, left ventricle (LV) mass, peak flow velocity on LV outflow tract, and fractional shortening (FS). Patients with stenosis of the carotid artery or its main intracranial branches were excluded, as were patients with major cerebral infarction, severe intracranial abnormality, or heart function disorder. The remaining 59 patients were subdivided according to the presence or absence of cerebral ischemic symptoms, diabetes mellitus, arterial hypertension, and hyperlipidemia for multivariate analyses and stepwise regressions. RESULTS: Women had smaller diameters and lower PI in the left and right CCA, and smaller LV mass than men. Age, CCA diameter, and IMT showed an inverse correlation with carotid flow velocities in several arterial segments. There was a positive correlation between PSV in the left CCA and ICA and FS, and between PSV in the left CCA and peak velocity on LV outflow tract. Flow velocities in the left and right ICA were significantly slower in patients with than in patients without cerebral ischemic symptoms. CONCLUSIONS: Cardiac hemodynamics and carotid flow velocities are significantly related, only on the left side, probably due to larger hemodynamic stress. Increased intracerebral circulatory resistance is probably involved in the decrease in carotid flow velocity and increase in PI in patients with cerebral ischemic symptoms.     

高血压合并冠心病患者血压变异性及动态血压的变化

[目的]分析高血压合并冠心痛患者的血压变异性与动态血压变化特点.[方法]选取2014年6月至2015年6月本院收治的160例高血压患者的临床资料.根据冠脉造影(CGA)结果或冠脉CT成像(CTA)诊断结果将其分为冠心病合并高血压组(n=80,观察组),单纯性高血压组(n=80,对照组),对两组患者动态血压和血压变异性指标进行分析比较.[结果]观察组患者日间平均收缩压、夜间平均收缩压、24h平均收缩压、日间平均脉压、夜间平均脉压、24h平均脉压、日间平均收缩压标准差、夜间平均收缩压标准差、24h平均收缩压标准差均显著高于对照组,差异有统计学意义(均P＜0.05);观察组与对照组患者在日间平均舒张压、夜间平均舒张压、24h平均舒张压、日间平均舒张压标准差、夜间平均舒张压标准差、24h平均舒张压标准差方面比较,差异均无统计学意义(均P＞0.05).[结论]高血压合并冠心病患者其动态血压波动比较大,且血压变异性相对增大,加强其血压动态血压与血压变异性监测对冠心病合并高血压的临床诊治有着一定的作用.     

Middle cerebral artery peak systolic velocity in monochorionic and dichorionic twin pregnancies.

OBJECTIVE: The purpose of this study was to compare middle cerebral artery (MCA) peak systolic velocity (PSV) values in monochorionic (MC) and dichorionic (DC) twin pregnancies. METHODS: This was a prospective cohort study in which MCA Doppler evaluation was performed in unselected twin pregnancies at time of routine sonography between 28 and 32 weeks. Pregnancies with known fetal anomalies, twin-twin transfusion syndrome, and red cell alloimmunization or other conditions associated with anemia were excluded. The intertwin MCA PSV difference, defined as the larger minus smaller PSV value within a pair, was compared in MC and DC pregnancies and was correlated with estimated fetal weight and birth weight discordance. Statistical analyses included Spearman correlation, analysis of variance, a t test, and a chi(2) test. RESULTS: Doppler indices were analyzed from 48 twin pregnancies, of which 32 (67%) were DC and 16 (33%) were MC. There was no difference in proportion of values above or below the singleton median for either the larger or smaller DC or MC twins (all P > or = .3). The median intertwin MCA PSV difference was 4.9 cm/s in MC pregnancies and 4.5 cm/s in DC pregnancies (P = .6). There was no significant correlation between the MCA PSV difference and either estimated fetal weight discordance or birth weight discordance in either MC or DC pregnancies (all P > or = .3). CONCLUSIONS: Middle cerebral artery PSV values in uncomplicated twin pregnancies are comparable with published singleton norms, with a median intertwin MCA PSV difference of approximately 5 cm/s. We found no significant correlation between the intertwin MCA PSV difference and discordance in MC or DC twin gestations.     

冷加压试验研究血压及血管反应性对动脉弹性参数的影响

目的 通过冷加压试验观察血压及血管反应性变化对动脉弹性参数测值的影响.方法 应用血管回声跟踪技术(ET)测暈冷加压试验中22名健康青年男性右侧颈总动脉的瞬时波强(WI),记录其中的动脉弹性参数:僵硬度(β)、弹性模量(Ep)、顺应性(AC)、膨大指数(A1)、β值推导的脉搏波传导速度(PWVβ)及WI值推导的脉搏波传导速度(PWV-WI),并与静息状态下的测值进行比较分析.结果 冷加压试验时,心率轻度加快(P相似文献   

个体化治疗模式对高血压维持性血液透析患者居家血压变异度的影响

目的 了解高血压血液透析（hemodialysis,HD）患者居家血压变异度状况,并观察根据HD患者高血压发病机制进行个体化治疗后,HD患者居家血压变异度的变化情况.方法 选取北京朝阳医院肾内科透析室部分稳定维持性HD患者进行家庭血压（Home-BP）监测,了解HD患者居家血压变异度情况,以居家血压的变异系数表示血压变异度.并以家庭收缩压≥150mmHg （1mmHg=0.133kPa）为未控制的高血压的诊断标准,对未控制的高血压患者进行生物电阻抗监测、透析前后血清钠测定、药物使用情况调查,了解水、钠负荷及药物应用合理性情况,进而针对性地分别进行降低干体质量、应用低钠透析液和合理使用降压药物的干预措施.随访2个月,观察患者血压及血压变异度情况. 结果 共有105例稳定维持HD患者进行家庭血压监测,患者居家血压变异度为（4.8±2.2/5.0±2.4）％.未控制的高血压患者有60例（57.1％）,经个体化降压治疗后,居家血压从（166.3±12.6/87.5±11.7） mmHg降至（154.1±14.2/82.6±11.4）mmHg（P＜0.001,t=7.223; t=4.796,P＜0.001）,收缩压变异度由（4.9±2.2）％降至（4.6±2.5）％ （P=0.340,t=0.961）.其中30例容量超负荷患者,予降低干体质量后,家庭收缩压和舒张压明显降低,变异系数分别下降0.4％和0.1％（P=0.027,t=2.329;P=0.041,t=2.138）.12例患者应用低钠透析液（136mmol/L）后,居家血压下降,血压变异度无明显改变.其余18例容量负荷正常、未使用低钠透析的患者通过增加肾素-血管紧张素抑制剂和αβ受体阻滞剂等,居家血压下降,血压变异度减小,但未达统计学差异.结论 针对高血压HD患者高血压的病因进行治疗,能够有效地改善患者的家庭血压及血压变异度.     

Probabilistic map of blood flow distribution in the brain from the internal carotid artery

Brain single photon emission computed tomographic (SPECT) images acquired after injecting Tc-99m-HMPAO into the internal carotid artery (ICA) during an intracarotid amobarbital procedure (IAP SPECT) provide anatomical information on the blood flow distribution from the ICA. In this study, probabilistic maps of the distribution of blood supply from the ICA were developed using the IAP SPECT images. Twenty-two sets of basal and IAP SPECT were collected from an existing database. IAP SPECT images were coregistered to basal SPECT images, and spatial normalization parameters used for basal SPECT images were reapplied to IAP SPECT for anatomical standardization. Pixel counts of IAP SPECT images were then normalized, and the probabilistic map of cerebral perfusion distribution (perfusion probabilistic map) for each hemisphere was determined by averaging the spatial/count-normalized IAP SPECT images. Population-based probabilistic maps representing the extent of ICA territory (extent probabilistic map) were also composed by averaging the binary images obtained by thresholding the spatially normalized IAP SPECT images. The probabilistic maps were used to quantify cerebral perfusion and reserve change after arterial bypass surgery in 10 patients with ICA stenosis. In the probabilistic maps, blood supply from the ICA was found to be most likely in the dorsolateral frontal lobe, the anterosuperior portion of the temporal lobe, and in the frontoparietal area. Of the subcortical regions, the striatum was found to be most likely to derive its blood supply from ICA. In patients with cerebral occlusive disease, improvements in basal perfusion and perfusion reserve in the bypass-grafted ICA territory were well identified and were increased by 6.2% and 4.6%, respectively, on average. The probabilistic maps developed in this study illustrate the perfusion distribution and extent of vascular territory for ICA and would be useful for objective evaluations of perfusion status in cerebrovascular disease.