【摘要】 目的了解80岁以上老老年高血压患者的动脉缓冲功能和内皮调节功能变化。方法采用高分辨率超声检测单纯收缩期高血压(ISH)和非单纯收缩期高血压(NISH,指收缩压与舒张压都升高)各10例患者在静息状态下的肱动脉横断面顺应性(CSC)、容积扩张性(VD),以及反应性充血时和舌下含服硝酸甘油后的内皮依赖性血管功能(FMD)和非内皮依赖性血管功能(NID),用于评估动脉的缓冲功能和内皮调节功能,并检测心脏功能。结果NISH组肱动脉横断面顺应性(CSC)、肱动脉容积扩张性(VD)均明显高于ISH组,差异有显著性(P=0·046,P<0·01),而动脉硬化指数(β)则明显小于ISH组,差异有显著性(P<0·01);在反应性充血状态下NISH组内皮依赖性血管舒张功能(FMD)亦明显高于ISH组(P=0·014)。左室后壁收缩期厚度(LPWS)NISH组则明显小于ISH组(P=0·031)。多因素分析结果FMD、β是与肱动脉容积扩张性(VD)关系最为密切的参数。结论两组患者动脉的缓冲功能和内皮调节功能均降低,同时ISH组患者动脉的缓冲功能和内皮调节功能明显低于NISH组患者。更多还原

【Abstract】 Objective To explore the relationship between artery buffering and endothelial function in senile hypertensive patients of > 80 years.Methods Doppler ultrasonography were applied to examine 10 isolated systolic hypertension( ISH) patients, 10 combined SBP and DBP hypertension (NISH) subjects. Brachial artery cross-sectional compliance(CSC),volumic distensibility(VD),flow-mediated vasodilation(FMD) after reactive hyperemia and nitroglycerin-induced vasodilation (NID)after sublingual glyceryl trinitrite were determined. Results CSC, VD in NISH were higher than those in ISH, (P=0.046, P<0.01). Aortic stiffenss index was lower than that in ISH( P<0.01);FMD in NISH was greater than that in ISH(P=0.014). Left ventricular posterior wall thickness(LPWS) in NISH was less than that in ISH (P=0.031). Conclusion Although artery buffering function and endothelial function in both two groups were decreased, the disorders was more significant in ISH than that in NISH.更多还原