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目的:探讨老年高血压患者中心动脉压与周围动脉压及左心功能的关系。方法:选择我院行左心导管术的老年患者84例,根据患者袖带法测定的肱动脉血压情况分为高血压组(52例)和非高血压组(32例),用导管测定两组患者升主动脉处中心动脉收缩压(CSP)和中心动脉舒张压(CDP);应用超声多普勒测定患者舒张期室间隔厚度(IVST)、左室后壁厚度(LVPWT)、舒张末期左室内径(LVDd)、左室射血分数(LVEF)等反映左心功能的指标。结果:①两组对象CSP均明显高于袖带法测定的肱动脉收缩压(P<0.05);CDP与肱动脉舒张压无统计学差异(P>0.01);高血压组CSP及CDP均高于非高血压组(P<0.05)。②高血压组IVST、LVPWT显著高于非高血压组(P<0.05);LVDd、LVEF显著低于非高血压组(P<0.05)。③随着心功能的降低,高血压患者中心动脉脉压升高,反射波增强,压力增高,压力增强指数比值增大(P<0.05)。结论:袖带法测量的肱动脉血压不能完全代表中心动脉血压,高血压患者中心动脉压的改变可以反映患者左心功能情况,中心动脉脉压升高、增强指数增加可能对高血压患者心血管事件有一定的预测价值。
Objective: To investigate the relationship between central arterial pressure and peripheral arterial pressure and left ventricular function in elderly patients with essential hypertension. Methods: Eighty-four elderly patients undergoing left-sided cardiac catheterization were divided into two groups according to cuff method: hypertension (52 cases) and non-hypertension (32 cases) The central artery systolic pressure (CSP) and central artery diastolic pressure (CDP) of the ascending aorta were measured in all the patients. The diastolic ventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT) LVDd, left ventricular ejection fraction (LVEF) and other indicators of left ventricular function. Results: ① The CSP of both groups were significantly higher than that of the brachial artery measured by cuff method (P <0.05); there was no significant difference between the diastolic blood pressure of CDP and brachial artery (P> 0.01) In non-hypertension group (P <0.05). ② The levels of IVST and LVPWT in hypertension group were significantly higher than those in non-hypertension group (P <0.05); LVDd and LVEF were significantly lower than those in non-hypertension group (P <0.05). ③ With the decrease of cardiac function, the central arterial pulse pressure increased, the reflected wave increased, the pressure increased and the ratio of pressure enhancement index increased (P <0.05). Conclusion: The brachial artery blood pressure measured by the cuff method can not completely represent the central arterial pressure. The changes of the central arterial pressure in the patients with hypertension can reflect the left ventricular function, the increase of the central arterial pressure and the increase of the exponential index may affect the cardiovascular function of hypertensive patients Events have a certain predictive value.