发性高血压左心室肥厚与颈动脉粥样硬化关系的临床研究

目的 探讨高血压患者颈动脉结构和血流动力学变化及颈动脉硬化程度与左心室肥厚（LVH）之间的关系。方法 采用多普勒超声技术观察168例高血压患者和120例健康对照者颈动脉病变及其血流动力学变化，同时测量左心室舒张末期内径、室间隔厚度、左心室后壁厚度，并计算左心室心肌重量指数。结果 LVH患者颈动脉斑块形成的发生率为71．28％。随EH危险分层增加，颈动脉IMT有增厚趋势，颈动脉斑块检出率也明显增加，明显高于对照组，并影响颈动脉的血流动力学（P〈0．01）。所有颈动脉参数在左室肥厚组与无左室肥厚组之间的差异均有统计学意义（P〈0．05），而颈动脉有斑块形成的患者左心室心肌重量指数、收缩压、舒张压均明显高于无斑块形成组（P〈0．01）。结论 EH患者颈动脉IMT增加与LVH密切相关，颈动脉硬化程度可作为预测LVH的参考指标。

Relationship between left ventricular hypertrophy of essential hypertension and carotid atherosclerosis

Objective To determine the prevalence of carotid artery atherosclerosis(CAS) in patients with essential hypertension(EH) and relation of left ventricular hypertriphy to carotid atherosclerosis.Methods Doppler and two-dimensional echocardiograph was performed in 168 patients with EH and 120 control subjects.To quantify the extent of CAS,the intimamedia thicknesses(IMT) of carotid artery,and left ventricular marker were measured.Results IMT was significantly thicker in the hypertension group.The percentage of detection of arterial plaque was also higher in hypertension group than in control group(72.1% vs 20.0%).IMT of carotid artery increased in hypertensive subjects of grades 2 and 3 when compared to control subjects and hypertensive subjects of grade 1.There was positive relation between IMT of carotid artery and LVMI(P<0.01).Conclusion IMT of carotid artery can increase in hypertensive patients and it is related to left ventricular hypertrophy.Carotid artery atherosclerosis is a good predictor for left ventricular hypertrophy.