老年高血压患者脉压及肱动脉内皮功能变化相关性探究.docVIP

老年高血压患者脉压及肱动脉内皮功能变化相关性探究 　［摘要］ 目的：探讨老年高血压患者脉压与肱动脉内皮功能变化的相关性。方法：对160例原发性高血压患者按脉压分成4组，在静息、反应性充血时和舌下含服硝酸甘油后应用B超分别检测其肱动脉舒张期内径，比较各脉压组在不同状态下其肱动脉舒张期内径的变化情况。结果：高血压患者随脉压增大，肱动脉扩张系数(DC)、横断面顺应性(CSC)逐渐减小，而硬度指数(β)逐渐增大；血流介导的血管扩张(FMD)在4组之间差异均有显著性(Plt;0.01)，脉压与FMD呈显著性负相关(r =-0.878，Plt;0.01)。结论：高血压患者脉压与肱动脉内皮功能密切相关，可作为评估、预测高血压患者动脉内皮功能的指标。　　［关键词］ 高血压；脉压；内皮功能；超声显像；肱动脉 ；相关性 　　The Research of Correlation Between Pulse Pressure and Endothelial Function of Brachial Artery in the Elderly Patients with Essential Hypertension 　　Abstract: Objective To explore the correlation between pulse pressure(PP) and endothelial function of Brachial artery in elderly patients with essentialwere selected，anddivided into four groups according to PP.Bmode ultrasound was applied to scanthe diameterofbrachial artery at rest and reactive hyperemia caused by flowdependent dilation and afte sublingual glyceryltrinitrate induced by endotheliumindependent di1atation. Then the diameter changes of brachia1 artery were compared between the four groups. Results The bigger PP, the less distensibility coefficient and crosssectional compliance and the bigger rigidity index of Brachial artery in elderly patients with essential hypertension. There were significantdifferences in the FMD between the four group(Plt;0.01)．PP had a strong correlativity with FMD , the bigger PP，the less FMD(r＝-0.878，Plt;0.01). Conclusion There was close relationship between PP and endothelial functionof brachial artery and PP was a more effective index to evaluate and forecastendothelial function of artery in patients with essential hypertension. 　　Key words：Hypertension; Pulse pressure; Endothelial function; Ultrasound graphy; Brachial artery; Correlation 　　原发性高血压是常见的疾病，是严重心脑血管事件的危险因素之一，严重危害人类的健康。脉压(pusle pressure , PP)是收缩压和舒张压之差值，是心血管事件的独立危险因子，与心血管事件危险性呈正相关，比动脉平均压、收缩压、舒张压在预测心血管事件危险性方面临床意义更大［1，2］。本研究以通过无创性的高频超声检测方法探讨老年高血压患者脉压与肱动脉内皮功能变化的相关性。 　　1　临床资料 　　门诊或住院的原发性高血压患者160 例，所有病例均符合高血压病诊断的国际统一标准，年龄52岁～78岁，平均(62.3±4.3)岁，其中男性84例，女性76例。所有患者至少2周内未服降压