CAJ | 학술논문

目的探讨脉搏波速度(PWV)升高的轻中度原发性高血压患者含服硝酸甘油后大动脉弹性的改变及临床意义.方法选取轻中度原发性高血压且测量PWV大于1400 cm/s的患者共779例,分为单纯高血压组(114例)、伴有1个危险因素组(262例)、伴有2个危险因素组(255例)及伴有3个危险因素组(148例),给予硝酸甘油0.5 mg含化后2 min重新测定血压及PWV,并进行统计学分析.结果患者含服硝酸甘油后收缩压由(149±15)mm Hg下降至(135±20)mm Hg,脉压由(59±12)mm Hg下降至(50±11)mm Hg,PWV由(1688±378)cm/s下降至(1329±288)cm/s,服药前后比较,差异均有统计学意义(t值分别为3.036、2.473、3.885,均P＜0.05);随着危险因素的增多,含服硝酸甘油后大动脉弹性改善程度减小;单纯高血压组、伴有1个危险因素组、伴有2个危险因素组、伴有3个危险因素或靶器官损害组PWV改善率分别为89.1%、74.3%、72.6%和44.0%.结论收缩压及脉压水平与大动脉弹性明显相关,含硝酸甘油后由于收缩压及脉压水平下降致大动脉僵硬度有所改善;高血压伴危险因素越多者血管弹性越差,且对硝酸甘油敏感性越差.
목적 탐토맥박파속도(PWV)승고적경중도원발성고혈압환자함복초산감유후대동맥탄성적개변급림상의의.방법 선취경중도원발성고혈압차측량PWV대우1400 cm/s적환자공779례,분위단순고혈압조(114례)、반유1개위험인소조(262례)、반유2개위험인소조(255례)급반유3개위험인소조(148례),급여초산감유0.5 mg함화후2 min중신측정혈압급PWV,병진행통계학분석.결과 환자함복초산감유후수축압유(149±15)mm Hg하강지(135±20)mm Hg,맥압유(59±12)mm Hg하강지(50±11)mm Hg,PWV유(1688±378)cm/s하강지(1329±288)cm/s,복약전후비교,차이균유통계학의의(t치분별위3.036、2.473、3.885,균P＜0.05);수착위험인소적증다,함복초산감유후대동맥탄성개선정도감소;단순고혈압조、반유1개위험인소조、반유2개위험인소조、반유3개위험인소혹파기관손해조PWV개선솔분별위89.1%、74.3%、72.6%화44.0%.결론 수축압급맥압수평여대동맥탄성명현상관,함초산감유후유우수축압급맥압수평하강치대동맥강경도유소개선;고혈압반위험인소월다자혈관탄성월차,차대초산감유민감성월차.
Objective To explore the changes of elasticity in the large arteries and its clinical significance of sublingual administration of nitroglycerin in patients with elevated PWV,and mild and moderate essential hypertension.Methods Totally,779 patients with mild and moderate hypertension and PWV more than 1400 cm/s were selected and divided into four groups,one with simple hypertension,the second one with only one risk factor for it,the third one with two risk factors,and the fourth one with three risk factors or damage in their target organs.Sublingual administration of 0.5 mg nitroglycerin was administered and blood pressure and PWV were measured for all of them.and data were statistically compared and analyzed by groups and before and after nitroglycerin administration.Results Systolic blood pressure decreased to(135±20)mm Hg from(149±15)mm Hg,pulse pressure decreased to(50±11)mm Hg from(59±12)mm Hg,PwV decreased to(1329±288)cm/s from(1688±378)cm/s,respectively,after nitroglycerin treatment for hypertensive patients(t=3.036,2.473,3.885,all P＜0.05).Improvement of elasticity of the large arteries in them after nitroglycerin treatment inversely correlated with the number of risk factors for hypertension they had,with 89.1 percent,74.3 percent,72.6percent and 44.0 percent of improvement in PWV,respectively for those with simple hypertension,only one risk factor.two risk factors and three risk factors or with damage in target organs.Conclusions Systolic blood pressure and pulse pressure significantly correlated with elasticity of the large arteries in hypertensive patients,and their stifiness improved after sublingual administration of nitroglycerin due to decrease in systolic blood pressure and pulse pressure.The more risk factors the hypertensive patients had,the poorer elasticity of their large arteries and less sensitive to nitroglycerin treatment were.