老年单纯收缩期高血压合并高脂血症肱动脉内皮功能研究

目的观察肱动脉内皮舒张功能(FMD)与老年单纯收缩期高血压(ISH)心血管危险因素和靶器官损害的相关性。方法90例ISH患者分为ISH组(n=51)和ISH合并高脂血症组(n=39),彩色多普勒超声测定肱动脉内皮舒张功能,并行颈动脉超声和心脏彩超检查。结果ISH组FMD显著高于ISH合并高脂血症组(P=0.021)。单变量分析显示,FMD与收缩压、颈动脉内膜—中膜厚度、胆固醇均呈负相关(P<0.01),与舒张压呈显著正相关(P<0.01);且颈动脉有斑块组和无斑块组FMD值有显著差异(P=0.001)。逐步回归模型显示,FMD仍然与收缩压和颈动脉内膜—中膜厚度存在显著负相关(P<0.01)。结论FMD与心血管危险因素有明显相关性,是一种无创评估老年高血压病合并心血管危险因素的较好方法。

Clinical study of flow-mediated dilatation of brachial artery in elder patients with isolated systolic hypertension combined with hyperlipidemia

Objective To investigate the relationship between flow-mediated dilatation of the brachial artery(FMD) and cardiovascular risk factors as well as target organ damage in elder patients with isolated systolic hypertension(ISH).Methods Ninety patients with ISH were divided into two groups: ISH group(n=51) and ISH with hyperlipidemia group(n=39).Color Doppler ultrasound for FMD was performed on all the patients,and carotid artery ultrasound and cardiac ultrasound were also conducted. Results Patiens with hyperlipidemia had lower FMD than those of ISH group(P=0.021).It was revealed by univariate analysis that FMD was negatively related to systolic blood pressure,carotid intima-media thickness and total cholesterol(P<0.01),while FMD was positively related to diastolic blood pressure(P<0.01).In addition,there was significant difference in FMD between patients with plaque and without plaque(P=0.001).It was indicated by stepwise multivariate regression analysis that FMD was still negatively related to systolic blood pressure and carotid intima-media thickness(P<0.01). Conclusion FMD is significantly correlated with cardiovascular risk factors and can serve as an accurate noninvasive method in assessing the cardiovascular risk factors in elder patients with isolated systolic hypertension.