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老年原发性高血压患者冠状动脉病变临床分析

Analysis of correlation of pulse pressure in senile essential hypertension with lesions in cervical and coronary arteries
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摘要 目的探讨老年原发性高血压患者冠状动脉病变的表现。方法51例老年原发性高血压患者按动态脉压分为〉60mmHg组25例和脉压40-60mmHg组26例,入选者做冠状动脉造影,应用超声检测双侧颈总动脉、分叉部、颈内动脉的内膜中层厚度,根据相关公式计算颈动脉紧张度,颈动脉扩张性,颈动脉僵硬度。以左右颈动脉系统全部宽块分级的总和计算宽块指数,作为评价颈动脉重构、粥样硬化程度的指标。结果脉压〉60mmHg组的颈总动脉内膜中层厚度为(0.94±0.15)mm颈动脉分叉处内膜中层厚度为(1.46±0.32)mm,颈动脉僵硬度为(3007.3±1022.47),均明显高于脉压40-60mmHg组(P〈0.01或P〈0.05)。而颈动脉扩张性为(0.12±0.08)、紧张度为(2.31±1.03),明显比脉压40-60mmHg组降低(P〈0.05或P〈0.01)。颈动脉粥样斑块发生率为92%、冠状动脉病变发生率为68%,脉压〉60mmHg组升高(P〈0.01或P〈0.05)。直线相关分析显示,颈总动脉内膜中层厚度、颈动脉分叉处内膜中层厚度、颈动脉僵硬度与脉压呈正相关(r分别为0.789、0.752、0.596,P〈0.01或P〈0.05)。颈动脉紧张度及颈动脉扩张性与脉压呈负相关(r分别为-0.626、-0.598,P〈0.05)。结论老年原发性高血压患者脉压增高,可使颈动脉粥样斑块及冠状动脉病变发生率增加。
出处 《中国热带医学》 CAS 2008年第6期979-980,982,共3页 China Tropical Medicine
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