高血压病患者动脉结构和功能的变化

目的：探讨高血压病患者早期动脉结构和功能的变化。方法：应用彩色多普勒超声技术，检测1~2级高血压病患者（n=55）主动脉、颈总动脉、肱动脉、桡动脉及眼动脉和视网膜动脉的收缩期和舒张期管腔内径、收缩期血流峰值速度、舒张末期血流速度、内膜中层厚度、搏动指数、阻力指数；计算内膜中层厚度/腔内径比值、最大剪切率、动脉扩张性和僵硬度、动脉横截面顺应性，同时设正常对照组(n=24)。结果：与对照组比较，高血压组主动脉、颈动脉、肱动脉舒张末期内径扩大，收缩期血流峰值速度减慢，最大剪切率降低，扩张性和横截面顺应性降低，而僵硬度和内膜中层厚度及其与管腔内径的比值显著增加(P<0.05或P<0.01)。桡动脉表现为内膜中层厚度及其与管腔内径的比值显著增加(P<0.01)，阻力指数增加(P<0.05)。眼动脉及视网膜动脉舒张末期血流速度明显减慢，阻力指数显著增加(P<0.05和P<0.01)。搏动指数在主动脉、颈动脉、肱动脉、桡动脉、眼动脉及视网膜动脉两组间比较差异均无显著性(P>0.05)。结论：高血压病早期即有动脉结构和功能的变化，其中以血管重塑，尤其是大中型动脉重塑性变化更为突出。

Changes of arterial structure and function in patients with hypertension

Objective To investigate the changes of arterial structure and function in patients with hypertension. Methods Structures and functions of aortic, carotid, brachial, radial, ophthalmic and retinal arteries were measured by Doppler ultrasound technique in 55 patients with mild to moderate hypertension. 24 normotensive subjects were served as control. Results The dimension (Ds), intima-media thickness (IMT) and IMT/D radial, resistance index (RI) and stiffness (S) were increased, while the peak velocity in systole (PVS) and maximal shear rate (SR), cross-sectional compliance (CSC) and distensibility in aortic, carotid and brachial arteries were decreased in hypertensive patients compared with controls (P<0.05 or P<0.01). IMT,IMT/D radial,and RI of radial artery were higher in hypertensive patients than those in control group (P<0.01 or P<0.05). The blood flow velocity of the end-diastolic phase of ophthalmic and central retinal artery were distinctly decreased,while RI was increased in hypertensive patients compared with controls(P<0.05 and P<0.01).There were no changes of PI in aortic, carotid, brachial, radial, ophthalmic and central retina arteries (P>0.05). Conclusion There are changes in arterial structure and function in mild-to-moderate essential hypertension, which are more significant in the vascular remodeling of large and moderate arteries.