Analysis of cerebral vascular hemodynamic changes in patients with essential hypertension

KONG Yu-Han; et al

doi:10.13406/j.cnki.cyxb.2010.04.009

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Analysis of cerebral vascular hemodynamic changes in patients with essential hypertension

更新时间：2024-01-17

- Analysis of cerebral vascular hemodynamic changes in patients with essential hypertension
- Journal of Chongqing Medical University Vol. 35, Issue 4, Pages: 622-625(2010)
- 作者机构：
  
  重庆医科大学附属第一医院神经内科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.2010.04.009
  CLC： R544.1
- Published：2010，
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[1]孔渝菡,秦新月,王永红.原发性高血压病人脑动脉血流动力学改变的特征分析[J].重庆医科大学学报,2010,35(04):622-625.

KONG Yu-Han, et al. Analysis of cerebral vascular hemodynamic changes in patients with essential hypertension. [J]. Journal of Chongqing Medical University 35(4):622-625(2010)
[1]孔渝菡,秦新月,王永红.原发性高血压病人脑动脉血流动力学改变的特征分析[J].重庆医科大学学报,2010,35(04):622-625. DOI： 10.13406/j.cnki.cyxb.2010.04.009.

KONG Yu-Han, et al. Analysis of cerebral vascular hemodynamic changes in patients with essential hypertension. [J]. Journal of Chongqing Medical University 35(4):622-625(2010) DOI： 10.13406/j.cnki.cyxb.2010.04.009.

摘要

目的:探讨高血压病患者脑血管血流动力学改变

为高血压病脑卒中的预防提供临床依据。方法:从参与健康体检人群中随机筛选2025人分为高血压病组892例

对照组1133例

其中高血压组按是否合并糖代谢和脂代谢紊乱再分为3个亚组。对研究对象进行病史、内外科、抽血等检查及颈部TCD检测

分析高血压不同时期、不同年龄段和合并不同代谢紊乱的收缩期血流速度（Systolic velocity

Vs）、舒张期血流速度（Diastolic velocity

Vd）、平均血流速度（Mean velocity

Vm）、阻力指数（Resistant index

RI）、搏动指数（Pulsatility index

PI）5个指标。结果:（1）原发性高血压病患者基底动脉Vs、Vm、Vd显著降低（P<0.01）

大脑中动脉Vd降低表现（P<0.05）

各期RI和PI值较正常组均有升高（P<0.01）。（2）高血压合并糖代谢紊乱组脑血流动力学改变最明显

Vm、Vd、RI、PI与其余各组均有差异。合并高脂血症组与单纯高血压组差异不明显。（3）青年高血压病患者TCD异常率为34.5%

以脑血管痉挛为主（69.2%）;老年高血压病患者TCD异常率79.0%

以动脉硬化为主（51.3%）。结论:原发性高血压可引起脑血管多种血流动力学改变

以基底动脉较为敏感

监测指标中以RI和PI最为敏感。TCD能较好反映原发性高血压病患者脑血管血流动力学改变及病变严重程度

其结果受年龄、血糖及血脂代谢紊乱等多种因素影响。

Abstract

Objective:Use transcranial Doppler ultrasound(TCD)to investigate cerebrovascular hemodynamic changes in patients with essential hypertension and provide clinical evidence for prevention of stroke.Methods:2 025 individuals who joined in physical examination were randomly selected and classified into two groups as hypertension group of 892 cases and control group of 1 133 cases.Hypertesion group is divided into 3 subgroups as normal hypertension group

complicated with glucose or lipid metabolism disorder groups.The main observational parameters through their TCD tests were systolic blood flow velocity(Vs)

diastolic blood flow velocity(Vd)

mean velocity(Vm)

resistant index(RI)

pulsatility index(PI).Results:(1)The basilar artery blood flow velocity(Vs

Vd)of patients with essential Hypertension were significantly lower than control group

Vd of middle cerebral artery decreased in hypertensive patients.On the other hand

RI and PI of the patients were higher than control group(P<0.01).(2)In hypertesion complicated with glucose metabolism disorder group

Vm and Vd decreased

RI and PI increased and has significant difference with the other groups.However

hypertesion complicated with hyperlipemia group didn’t show significance with pure hypertension group.(3)The abnormal possibility of TCD in young hypertensive patients is 34.5%.The major cause is cerebral vasospasm(69.2%).The abnormal possibility in older hypertensive patients is 79.0%

the major cause is angiosclerosis(51.3%).Conclusion:Early essential hypertension can cause functional changes in cerebral vessels

basilar artery is especially sensitive.TCD can reflect cerebrovascular hemodynamic changes and cerebral flow velocity is influenced by multiple interacting factors such as age

diabetes and hyperlipemia.

关键词

高血压经颅多普勒血流动力学脑卒中

Keywords

hypertensionDoppler transcranial sonographyHemodynamicstroke

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