H型高血压与腔隙性脑梗死患者血流动力学变化的相关研究(1)
摘 要：目的 初步探讨H型高血压与腔隙性脑梗死患者血流动力学变化的影响。方法 选取2017年3月～2018年4月在亳州市人民医院就诊的腔隙性脑梗死患者90例，依据血浆同型半胱氨酸水平及是否伴有高血压，将腔隙性脑梗死患者分成H型高血压组47例和非H型高血压组43例。利用颈部血管彩超评价入组患者的颈部血流动力学状态，比较两组患者血流动力学参数的差异。结果 H型高血压组患者Vmax[(31.23±6.75)cm/s vs (34.53±4.23)cm/s]、Vmin[(5.24±2.01)cm/s vs (8.44±1.40)cm/s]、Vmean[(12.71±3.03)cm/s vs (16.81±2.17)cm/s]、Qmean[(7.37±1.43)ml/s vs (8.38±1.04)ml/s]均低于非H型高血壓组，差异具有统计学意义(P<0.05)。H型高血压组患者PI(2.08±0.32 vs 1.56±0.21)和RI(0.84±0.45 vs 0.75±0.21)均高于非H型高血压组，差异具有统计学意义(P<0.05)。结论 H型高血压显著降低腔隙性脑梗死患者的血流速度，H型高血压是腔隙性脑梗死患者的危险因素。
, 百拇医药
关键词：H型高血压;血浆同型半胱氨酸;腔隙性脑梗死;血流动力学
中图分类号：R544.1;R743.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.020
文章编号：1006-1959(2018)24-0078-04
Abstract：Objective To investigate the effects of hemodynamic changes in patients with H-type hypertension and lacunar infarction. Methods A total of 90 patients with lacunar infarction who were admitted to the People's Hospital of Bozhou city from March 2017 to April 2018 were enrolled. Patients with lacunar infarction were divided according to plasma homocysteine level and hypertension. There were 47 patients with H-type hypertension and 43 patients with non-H-type hypertension. The cervical hemodynamic status of the patients was evaluated by cervical vascular ultrasonography， and the differences in hemodynamic parameters between the two groups were compared. Results Vmax in patients with H-type hypertension [(31.23±6.75) cm/s vs (34.53±4.23) cm/s]， Vmin[(5.24±2.01) cm/s vs (8.44±1.40) cm/s]， Vmean [(12.71±3.03) cm/s vs (16.81±2.17) cm/s]， Qmean [(7.37±1.43) ml/s vs (8.38±1.04) ml/s] were lower than non-H type hypertension group， the difference was statistically significant (P<0.05). Patients with H-type hypertension had higher PI (2.08±0.32 vs 1.56±0.21) and RI (0.84±0.45 vs 0.75±0.21) than non-H-type hypertension group， the difference was statistically significant (P<0.05). Conclusion H-type hypertension significantly reduces the blood flow velocity in patients with lacunar infarction. H-type hypertension is a risk factor for patients with lacunar infarction.
, http://www.100md.com
Key words：H-type hypertension;Plasma homocysteine;Lacunar infarction;Hemodynamics
腔隙性脑梗死(lacunar infarction，LI)属于缺血性卒中的一个重要亚型，发病率约占缺血性卒中的25%[1]。最近的研究表明，腔隙性脑梗死的近期死亡率和致残率相对较低，复发率较高，与其他缺血性卒中具有相似的复发风险，腔隙性梗死的远期预后不良性，发生认知功能障碍的风险增加，最终导致痴呆和死亡[2，3]。高血压是公认的引起腔隙性脑梗死的重要危险因素[4]，而我国75%原发性高血压患者常伴有血浆同型半胱氨酸(total homocysteine，tHcy)水平升高(≥10 μmol/L)，二者具有协同作用，学者把伴有血浆tHcy水平升高的高血压称为H型高血压[5]。利用超声多普勒血流探头检测双侧颈动脉血液循环动力学的变化，可以全面评价被检患者脑血管床的动力学特征和血液运动状态，综合评估被检查的脑血管功能状况。本文探讨H型高血压对腔隙性脑梗死患者脑血管功能的影响，为腔隙性脑梗死患者的预防提供一定的参考。, http://www.100md.com(马孝天 余书康 李贯清)
, 百拇医药
关键词：H型高血压;血浆同型半胱氨酸;腔隙性脑梗死;血流动力学
中图分类号：R544.1;R743.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.020
文章编号：1006-1959(2018)24-0078-04
Abstract：Objective To investigate the effects of hemodynamic changes in patients with H-type hypertension and lacunar infarction. Methods A total of 90 patients with lacunar infarction who were admitted to the People's Hospital of Bozhou city from March 2017 to April 2018 were enrolled. Patients with lacunar infarction were divided according to plasma homocysteine level and hypertension. There were 47 patients with H-type hypertension and 43 patients with non-H-type hypertension. The cervical hemodynamic status of the patients was evaluated by cervical vascular ultrasonography， and the differences in hemodynamic parameters between the two groups were compared. Results Vmax in patients with H-type hypertension [(31.23±6.75) cm/s vs (34.53±4.23) cm/s]， Vmin[(5.24±2.01) cm/s vs (8.44±1.40) cm/s]， Vmean [(12.71±3.03) cm/s vs (16.81±2.17) cm/s]， Qmean [(7.37±1.43) ml/s vs (8.38±1.04) ml/s] were lower than non-H type hypertension group， the difference was statistically significant (P<0.05). Patients with H-type hypertension had higher PI (2.08±0.32 vs 1.56±0.21) and RI (0.84±0.45 vs 0.75±0.21) than non-H-type hypertension group， the difference was statistically significant (P<0.05). Conclusion H-type hypertension significantly reduces the blood flow velocity in patients with lacunar infarction. H-type hypertension is a risk factor for patients with lacunar infarction.
, http://www.100md.com
Key words：H-type hypertension;Plasma homocysteine;Lacunar infarction;Hemodynamics
腔隙性脑梗死(lacunar infarction，LI)属于缺血性卒中的一个重要亚型，发病率约占缺血性卒中的25%[1]。最近的研究表明，腔隙性脑梗死的近期死亡率和致残率相对较低，复发率较高，与其他缺血性卒中具有相似的复发风险，腔隙性梗死的远期预后不良性，发生认知功能障碍的风险增加，最终导致痴呆和死亡[2，3]。高血压是公认的引起腔隙性脑梗死的重要危险因素[4]，而我国75%原发性高血压患者常伴有血浆同型半胱氨酸(total homocysteine，tHcy)水平升高(≥10 μmol/L)，二者具有协同作用，学者把伴有血浆tHcy水平升高的高血压称为H型高血压[5]。利用超声多普勒血流探头检测双侧颈动脉血液循环动力学的变化，可以全面评价被检患者脑血管床的动力学特征和血液运动状态，综合评估被检查的脑血管功能状况。本文探讨H型高血压对腔隙性脑梗死患者脑血管功能的影响，为腔隙性脑梗死患者的预防提供一定的参考。, http://www.100md.com(马孝天 余书康 李贯清)