原发性高血压患者经颅多谱勒脑动脉血流变化特征分析

目的 探讨原发性高血压患者脑动脉血流变化特征及其影响因素，为高血压防治提供依据。方法 对29名原发性高血压患者和16名健康人进行了经颅彩色多普勒脑血流成像技术（TCI）监测分析，观察大脑中动脉（MCA）的收缩期血流速度（Vs)平均血流速度（Vm)、舒张期血流速度（Vd)、搏动指数（PI）、阻力指数（RI）的变化特征，并与收缩压（SBP）、舒张压（DBP）、平均动脉压（MBP）、脉压进行了直线相关分析。结果 与健康对照组相比，高血压组患者收缩压（SBP）、舒张压（DBP）、平均动脉压（MBP）、脉压和体重指数（BMI）及PI、RI均明显升高（P＜0．01）；高血压组中DBP与Vs,Vm,Vd,PI,RI呈明显正相关（P＜0．05），脉压与Vs,Vm,Vd及PI呈明显正相关（P＜0．05）。SBP、MBP均与脑血流指标相关不明显（P＞0．05）。结论 高血压患者脑动脉血流变化特征主要表现为PI和RI的显著升高，舒张压和脉压是影响脑血流变化的两个主要因子。TCI是一种简便的、有价值的检查方法。

The Changes of Cerebral Circulation in Essential Hypertension Patients

Objective To observe the changes of cerebral arteries blood flow in essential hypertensive(EH) patients. Methods Transcranial Doppler cerebral blood flow image was performed in 29 EH patients and 16 healthy subjects. Systolic velocity(Vs),mean velocity(Vm),diastolic velocity(Vd),pulsatility index(PI) and resistant index(RI) of main medium-large cerebral arteries were obtained. Body mass index(BMI),systolic blood pressure(SBP), diastolic blood pressure(DBP),mean artery blood pressure(MAP) and pulse pressure(PP) were measured. We also analyzed the correlation between blood pressure levels and TCI parameters. Results Compared with the healthy control group, BMI,SBP,DBP,MBP,PP, and PI ,RI of cerebral arteries were significantly increased in EH patients( P <0 01). Vs,Vd,Vm,PI,RI parameters were significantly positively correlated with DBP. Vs,Vd,Vm,PI parameters were also significantly positively correlated with PP ( P <0 05). No significant correlation between SBP,MBP and TCI parameters was observed. ( P >0 05). Conclusion EH patients usually have abnormal changes of cerebral blood flow.