中华医学超声杂志（电子版）
中華醫學超聲雜誌（電子版）
중화의학초성잡지（전자판）
CHINESE JOURNAL OF MEDICAL ULTRASOUND(ELECTRONICAL VISION)
2014年
6期
493-497
,共5页
超声检查%高血压%血压%动脉粥样硬化%颈动脉
超聲檢查%高血壓%血壓%動脈粥樣硬化%頸動脈
초성검사%고혈압%혈압%동맥죽양경화%경동맥
Ultrasonography%Hypertension%Blood pressure%Atherosclerosis%Carotid arteries
目的：探讨老年高血压病患者脉压及血压昼夜节律异常对颈动脉粥样硬化斑块形成的影响。方法150例老年原发性高血压患者根据24 h动态血压检测结果，按照昼夜血压下降率分为2组，＜10%为非杓型组（72例），≥10%为杓型组（78例）。超声检测颈动脉粥样硬化斑块程度及性质，并对斑块进行分级。计算不同脉压水平[≤60 mmHg（1 mmHg=0.133 kPa）、61~89 mmHg、≥90 mmHg]高血压患者颈动脉斑块检出率。结果杓型组高血压病患者中检出斑块61例，位于双侧20例，右侧15例，左侧26例，斑块检出率为78%（61/78）；非杓型组高血压病患者中检出斑块68例，位于双侧38例，右侧14例，左侧16例，斑块检出率为94%（68/72）。非杓型组斑块检出率高于杓型组，差异有统计学意义（χ2=8.07，P＜0.01）。杓型组中硬斑30例、软斑13例、混合斑8例，非杓型组中硬斑12例、软斑24例、混合斑32例；杓型组中斑块分级为0级、1级、2级、3级的患者分别为17、33、13、15例，非杓型组中0级、1级、2级、3级的患者分别为6、8、25、33例。2组患者斑块性质及斑块分级的差异均有统计学意义（χ2=5.29、8.75，P均＜0.01）。43例患者脉压≤60 mmHg，斑块检出率为72%（30/43）；65例脉压为61~89 mmHg，斑块检出率为88%（57/65）；42例脉压≥90 mmHg，斑块检出率为98%（41/42）。脉压≤60 mmHg、61~89 mmHg、≥90 mmHg的高血压病患者斑块检出率间差异有统计学意义（χ2=11.65，P=0.00）。结论脉压增大及血压昼夜节律异常是颈动脉粥样硬化斑块形成的危险因素。
目的：探討老年高血壓病患者脈壓及血壓晝夜節律異常對頸動脈粥樣硬化斑塊形成的影響。方法150例老年原髮性高血壓患者根據24 h動態血壓檢測結果，按照晝夜血壓下降率分為2組，＜10%為非杓型組（72例），≥10%為杓型組（78例）。超聲檢測頸動脈粥樣硬化斑塊程度及性質，併對斑塊進行分級。計算不同脈壓水平[≤60 mmHg（1 mmHg=0.133 kPa）、61~89 mmHg、≥90 mmHg]高血壓患者頸動脈斑塊檢齣率。結果杓型組高血壓病患者中檢齣斑塊61例，位于雙側20例，右側15例，左側26例，斑塊檢齣率為78%（61/78）；非杓型組高血壓病患者中檢齣斑塊68例，位于雙側38例，右側14例，左側16例，斑塊檢齣率為94%（68/72）。非杓型組斑塊檢齣率高于杓型組，差異有統計學意義（χ2=8.07，P＜0.01）。杓型組中硬斑30例、軟斑13例、混閤斑8例，非杓型組中硬斑12例、軟斑24例、混閤斑32例；杓型組中斑塊分級為0級、1級、2級、3級的患者分彆為17、33、13、15例，非杓型組中0級、1級、2級、3級的患者分彆為6、8、25、33例。2組患者斑塊性質及斑塊分級的差異均有統計學意義（χ2=5.29、8.75，P均＜0.01）。43例患者脈壓≤60 mmHg，斑塊檢齣率為72%（30/43）；65例脈壓為61~89 mmHg，斑塊檢齣率為88%（57/65）；42例脈壓≥90 mmHg，斑塊檢齣率為98%（41/42）。脈壓≤60 mmHg、61~89 mmHg、≥90 mmHg的高血壓病患者斑塊檢齣率間差異有統計學意義（χ2=11.65，P=0.00）。結論脈壓增大及血壓晝夜節律異常是頸動脈粥樣硬化斑塊形成的危險因素。
목적：탐토노년고혈압병환자맥압급혈압주야절률이상대경동맥죽양경화반괴형성적영향。방법150례노년원발성고혈압환자근거24 h동태혈압검측결과，안조주야혈압하강솔분위2조，＜10%위비표형조（72례），≥10%위표형조（78례）。초성검측경동맥죽양경화반괴정도급성질，병대반괴진행분급。계산불동맥압수평[≤60 mmHg（1 mmHg=0.133 kPa）、61~89 mmHg、≥90 mmHg]고혈압환자경동맥반괴검출솔。결과표형조고혈압병환자중검출반괴61례，위우쌍측20례，우측15례，좌측26례，반괴검출솔위78%（61/78）；비표형조고혈압병환자중검출반괴68례，위우쌍측38례，우측14례，좌측16례，반괴검출솔위94%（68/72）。비표형조반괴검출솔고우표형조，차이유통계학의의（χ2=8.07，P＜0.01）。표형조중경반30례、연반13례、혼합반8례，비표형조중경반12례、연반24례、혼합반32례；표형조중반괴분급위0급、1급、2급、3급적환자분별위17、33、13、15례，비표형조중0급、1급、2급、3급적환자분별위6、8、25、33례。2조환자반괴성질급반괴분급적차이균유통계학의의（χ2=5.29、8.75，P균＜0.01）。43례환자맥압≤60 mmHg，반괴검출솔위72%（30/43）；65례맥압위61~89 mmHg，반괴검출솔위88%（57/65）；42례맥압≥90 mmHg，반괴검출솔위98%（41/42）。맥압≤60 mmHg、61~89 mmHg、≥90 mmHg적고혈압병환자반괴검출솔간차이유통계학의의（χ2=11.65，P=0.00）。결론맥압증대급혈압주야절률이상시경동맥죽양경화반괴형성적위험인소。
Objective To observe the impact of pulse pressure (PP) and blood pressure (BP) circadian rhythm abnormality of aged hypertension patients on carotid atherosclerosis. Methods One hundred and fifty cases of elderly patients with essential hypertension based on 24 h ambulatory blood test results, according to the circadian blood pressure rates were divided into two groups,<10% in the non-dipper type hypertension group (72 cases),≥10%in the dipper type hypertension group (78 cases). Carotid ultrasound was performed to detect the extent, nature and classification of atherosclerotic plaques. The detection rate of carotid artery plaque in patients with hypertension was calculated based on their pulse pressure levels:≤60 mmHg (1 mmHg=0.133 kPa), 61~89 mmHg, ≥90 mmHg. Results Ultrasonography showed 61 cases of carotid artery plaques in the dipper type hypertension group, 20 cases were located bilaterally, 15 cases were in the right, 26 cases were in the left, the detection rate of plaque was 78%(61/78). Ultrasonography showed 68 cases of carotid artery plaques in the non-dipper type hypertension group, 38 cases were located bilaterally, 14 cases were in the right, 16 cases were in the left, the detection rate of plaque was 94%(68/72). The detection rate of plaque in the dipper type hypertension group was less than that in the non-dipper type hypertension group, the difference was statistically significant (χ2=8.07, P<0.01). There were 30 cases of hard plaque,13 cases of soft plaque, 8 cases of mixed plaque, and the plaques graded as 0, 1, 2, 3 were 17, 33, 13, 15 cases in dipper type hypertension group. There were 12 cases of hard plaque, 24 cases of soft plaque, 32 cases of mixed plaque, and the plques graded as 0, 1, 2, 3 were 6, 8, 25, 33 cases in non-dipper type hypertension group. The difference was statistically signiifcant (χ2=5.29, 8.75, both P < 0.01). Forty three patients with pulse pressure≤60 mmHg, the plaque detection rate was 72%(30/43);the pulse pressure of 65 cases was 61~89 mmHg, the plaque detection rate was 88%(57/65);42 cases with vein pressure ≥ 90 mmHg, the plaque detection rate was 98%(41/42). The difference was statistically signiifcant (χ2=11.65, P=0.00). Conclusion Pulse pressure increased and BP circadian rhythm abnormality are risk factors for the formation of carotid atherosclerosis.
