【摘要】 目的探讨高龄老年H型高血压患者颈动脉结构及功能的变化。方法选择2013年3月~2015年10月重庆三峡中心医院老年科收治的169例老年(年龄≥60岁)高血压患者作为研究对象,根据年龄和同型半胱氨酸(Hcy)水平分为高龄(年龄≥80岁)H型高血压组(H1组)59例,低龄(60岁≤年龄<80岁)H型高血压组(H2组)56例,低龄非H型高血压组(NH组)54例。通过对各组患者颈部血管的彩色超声检查及Hcy、血脂水平的测定,分析H型高血压患者颈动脉结构、功能的变化及其与年龄、血脂水平的关系。结果 H1组的高密度脂蛋白胆固醇(HDLC)水平、年龄明显高于H2组、NH组(P<0.05),H1组、H2组的Hcy水平明显高于NH组(P<0.05),H1、NH组患者颈动脉内-中膜厚度(IMT)均低于H2组(P<0.05),H1、NH组硬斑、纤维斑块的比例高于H2组(P<0.05),软斑、混合斑块的比例低于H2组(P<0.05)。患者的颈动脉IMT与HDLC水平呈负相关(r=-0.161,P<0.01),与Hcy水平呈正相关(r=0.324,P<0.01)。结论高血压患者动脉硬化严重程度及进展与年龄、Hcy水平密切相关。更多还原

【Abstract】 Objective To investigate the carotid artery structure and function impairments in advanced aged patients with H type hypertension by carotid ultrasonography. Methods From April 2013 to October, in Department of Geriatric,Chongqing Three Gorges Central Hospital, 169 elderly patients(age≥60 years) with hypertension were selected as object of study, they were divided into advanced aged(age≥80 years) H type hypertension group(H1 group, n=59), aged(60 years ≤age <80 years) H type hypertension group(H2 group, n =56), aged non-H type hypertension group(NH group, n=54). Their carotid artery structure and function and the level of cholesterol, homocysteine were measured, the correlation between age, the level of cholesterol, homocysteine and the severity of carotid artery atherosclerosis were analyzed. Results The level of HDLC, age in H1 group was significantly higher than those in H2 group and NH group(P < 0.05), the level of Hcy in H1 group and H2 group was significantly higher than that in NH group(P < 0.05), the IMT in H1 group and NH group was significantly lower than that in H2 group(P < 0.05). The incidence of calcified hard plaque and fibrous plaque in H1 group and NH group were significantly higher than those in H2 group(P < 0.05),but the incidences of soft plaque and hybrid plaque in H1 group and NH group were significantly lower than those in H2 group(P < 0.05). IMT was negatively related with HDLC(r =-0.161, P < 0.01), positively related with Hcy(r =0.324, P < 0.01). Conclusion The severity and development process of artery atherosclerosis in hypertension patients is more closely with age and the level of Hcy.更多还原