高血压合并脂代谢紊乱对颈动脉重构的影响

目的:观察伴有或不伴有血脂代谢紊乱的高血压患者的颈动脉内膜-中膜厚度(IMT)和颈动脉内径、扩张性及僵硬度,探讨血脂在高血压患者颈动脉重构中的作用.方法:入选对象172例,其中正常对照组50例,高血压血脂正常组62例,高血压血脂紊乱组60例,未服用过他汀类、贝特类及烟酸等调脂药物.通过颈动脉超声测定颈动脉IMT和内径,并计算颈动脉扩张性及颈动脉僵硬度.结果:IMT、内径、僵硬度高血压血脂正常组显著高于正常对照组(P＜0.05),高血压血脂紊乱组则高于高血压血脂正常组(P＜0.05).颈动脉扩张性高血压血脂正常组较正常对照组显著降低(P＜0.05),高血压血脂紊乱组较高血压血脂正常组也显著降低(P＜0.05).低密度脂蛋白胆固醇(LDL-C)与颈动脉IMT(r=0.318,P＜0.01)、内径(r=0.333,P＜0.01)呈正相关,高密度脂蛋白胆固醇(HDL-C)与颈动脉IMT及内径无明显相关(r分别为0.038和0.078,均P＞0.05).结论:高血压合并血脂紊乱可对颈动脉重构起到促进作用,其中LDL-C升高型血脂代谢紊乱影响更为显著,而HDL-C与颈动脉重构无明显相关.

Effects of the Disordered Lipid Metabolism on Carotid Artery Remodelling in Hypertensive Patients

Objective:To investigate the effects of the disordered lipid metabolism on carotid artery remodelling in hy-pertensive patients. Methods: One hundred and seventy-two people were divided into three groups : normotention subjects( n = 50); hypertensive subjects without disordered lipid metabolism ( n = 62); hypertensive subjects with disordered lipid metabolism( n = 60). The intima - media thickness ( IMT) and diameter were measured by high resolusion B - mode ultra-sound in 172 subjects to disscus the relationship between LDL-C, HDL-C and IMT, diameter. Results: There was no signifi-cant difference in sex, age, smoking history,drinking history and body mass index in three groups ( P > 0.05). IMT , diameter and stiffness of the hypertensive subjects without disordered lipid metabolism were higher than that of normal subjects. IMT , diameter and stiffness of the hypertensive subjects with disordered lipid metabolism were higher than that of hypertensive subjects without disordered lipid metabolism. LDL - C had a positive correlation with IMT ( r = 0. 318 , P < 0. 01) and diameter ( r = 0. 333 , P < 0. 01)of carotid artery ,and HDL - C had not correlation with IMT and ID of carotid artery(r = 0.038, P > 0.05; r = 0.078, P > 0.05). Conslusion:The hypertension with disordered lipid metabolism ,especially the high LDL-C,can promote the remodeling of carotid artery.