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目的探讨高血压(HT)无症状性患者颅内动脉狭窄的特点和相关因素。方法对288例高血压患者进行经颅多普勒(TCD)检查有无颅内动脉狭窄以及狭窄的分布特点,采集患者一般资料、血压、血脂谱等。结果①TCD检出颅内动脉狭窄63例(21.88%),查动脉1958条,狭窄88条(4.49%),大脑中动脉(MCA)是最易受累的动脉;②狭窄患者的年龄≥65岁、HT病程≥20年,吸烟的构成比显著高于非狭患者;③狭窄患者的收缩压、脉压差、TC、TG和LDL-C显著高于非狭窄患者;④多因素Logistic回归分析显示:脉压差、年龄、高血压病程和吸烟是影响动脉狭窄的独立因素。结论颅内动脉狭窄可能是HT发生缺血性脑卒中潜在的中间环节,脉压差、年龄、高血压病程和吸烟是HT无症状颅内动脉狭窄的独立因素,良好的血压控制和戒烟对HT患者脑血管事件的发生具有保护作为。
Objective To investigate the characteristics and related factors of intracranial arterial stenosis in patients with asymptomatic hypertension (HT). Methods 288 cases of hypertensive patients were transcranial Doppler (TCD) with or without intracranial artery stenosis and distribution of stenosis, collecting general information of patients, blood pressure, blood lipid profile. Results ① TCD detected 63 cases of intracranial arterial stenosis (21.88%), 1958 arteries examined, 88 cases (4.49%) stenosis, the middle cerebral artery (MCA) was the most vulnerable artery; ② stenosis of patients aged ≥ 65 years, HT of 20 years, the constituent ratio of smoking was significantly higher than that of non-narrow-matched patients; ③the systolic blood pressure, pulse pressure difference, TC, TG and LDL-C in stenosis patients were significantly higher than those in non-stenosis patients; ④Multivariate Logistic regression analysis showed that: Pulse pressure, age, duration of hypertension and smoking are independent factors affecting arterial stenosis. Conclusion Intracranial arterial stenosis may be the potential intermediate link of ischemic stroke in stroke HT. Pulse pressure, age, duration of hypertension and smoking are the independent factors of HT asymptomatic intracranial artery stenosis. Good blood pressure control and smoking cessation have a positive effect on HT The occurrence of cerebrovascular events in patients has a protective role.