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目的:初步探讨中青年难治性高血压(RH)患者的心脏、血管弹性的变化。方法:选择中青年(18~65岁)RH患者、可控性高血压(CH)患者和血压正常(NT)者各50例,分别检测中心动脉压、颈股脉搏波传导速度(cf PWV)、增强指数(AIx@75%)、左室结构、左室舒张功能(E/e)和血流动力学等参数,计算心室-动脉耦联等指标。结果:cfPWV值RH组高于CH组及NT组(均P<0.05),CH组高于NT组(P<0.05)。有效动脉弹回(Ea)、左室收缩末弹回(Ees)、左室舒张末弹回(Eed)值RH组高于CH及NT组(均P<0.05)。多因素线性回归分析显示,在总体人群中AIx@75%是心室-动脉耦联指数的独立危险因素。结论:中青年RH患者的心室及动脉僵硬增加,心室-动脉匹配关系发生了变化。
Objective: To investigate the changes of heart and blood vessel elasticity in middle-aged and young patients with refractory hypertension (RH). Methods: Fifty patients with RH, aged 18 ~ 65 years old, controlled CH (hypertension) and NT (normotensive) were enrolled in this study. Central gas pressure, CF PWV, , Enhancement index (AIx @ 75%), left ventricular structure, left ventricular diastolic function (E / e) and hemodynamics parameters were calculated and ventricular-arterial coupling index was calculated. Results: The cfPWV value in RH group was higher than that in CH group and NT group (all P <0.05), and CH group was higher than NT group (P <0.05). Ea, Ees and Eed in RH group were higher than those in CH and NT groups (all P <0.05). Multivariate linear regression analysis showed that AIx @ 75% was an independent risk factor for ventricular-arterial coupling index in the general population. Conclusions: The stiffness of ventricles and arteries in middle-aged and young patients with RH is increased, and the ventricular-arterial matching changes.