颅内动脉系统的血流动力学负荷在受试者遭受出血性中风作为原发性动脉高血压的并发症

V. Netiazhenko, O. Tkachyshyn
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引用次数: 0

摘要

本研究的目的是比较出血性卒中后≥6个月的原发性动脉高血压患者组和无并发症的原发性动脉高血压患者组之间,通过24小时动态血压监测和颈大动脉超声指标来评估颅内动脉系统的血流动力学负荷。第一组为主要组(n=94;年龄- 54.4±0.9岁),М±m),第二组-对照组(n=104;年龄- 53.7±0.9岁)。主组和对照组24小时动态血压监测指标:白天收缩压平均值分别为109.6±1.6和121.1±1.1 mm Hg,最小值分别为74.4±2.0和82.3±12.5 mm Hg,最大值分别为168.2±1.9和161.9±1.7 mm Hg, p<0.05。日间收缩压sigma(17.9±0.6)和平均真实变异性收缩压(11.31±2.52 mm Hg)显著高于对照组(p<0.01)。白天收缩压高压负荷指数主要组为403.6±25.9,对照组为231.7±12.1 mm Hg × h (p<0.01)。24h最大脉压分别为74.2±2.0 mm Hg和66.4±0.9 mm Hg (p<0.01)。主组颈大动脉左右血管超声指标:颈总动脉高斯林脉搏指数为1.578±0.059、1.552±0.042,颈内动脉高斯林脉搏指数为1.210±0.044、1.102±0.037,椎动脉高斯林脉搏指数为1.191±0.030、1.150±0.023。主组以上指标均大于对照组(p<0.01)。主组颈大动脉直径均大于对照组(p<0.01)。因此,根据上述脑血管事件发生风险较大的相关指标,主组颅内动脉系统血流动力学负荷明显大于对照组,但平均收缩压指标较小。
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Hemodynamic load on the intracranial arterial system in subjects who have suffered a hemorrhagic stroke as a complication of essential arterial hypertension
The aim of the investigation was to compare a hemodynamic load on the intracranial arterial system, assessed by the indices of 24-hours ambulatory blood pressure monitoring and ultrasonography of the large cervical arteries between the group of patients with essential arterial hypertension in ≥6 months after a hemorrhagic stroke and a group of patients with essential arterial hypertension without complications. The first one was the main group (n=94; age – 54.4±0.9 years), М±m), the second one – the comparison group (n=104; age – 53.7±0.9 years). The indices of 24-hours ambulatory blood pressure monitoring in the main group and the comparison group were the following: the mean daytime systolic blood pressure was 109.6±1.6 and 121.1±1.1 mm Hg, the minimal one was 74.4±2.0 mm Hg and 82.3±12.5 mm Hg, and the maximal one was 168.2±1.9 and 161.9±1.7 mm Hg, p<0.05. The daytime systolic blood pressure sigma (17.9±0.6) and the average real variability of systolic blood pressure (11.31±2.52 mm Hg) were bigger in the main group (p<0.01). The daytime index of hyperbaric load of systolic blood pressure was bigger in the main group: it was 403.6±25.9 against 231.7±12.1 mm Hg × h in the comparison group (p<0.01). The maximal pulse pressure for a 24-hours interval was 74.2±2.0 and 66.4±0.9 mm Hg, respectively (p<0.01). The indices of ultrasonography of the large cervical arteries in the right and left vessels of the main group were the following: the Gosling's pulsatility index was 1.578±0.059 and 1.552±0.042 for the common carotid artery, 1.210±0.044 and 1.102±0.037 for the internal carotid artery, 1.191±0.030 and 1.150±0.023 for the vertebral artery. The above-mentioned indices were bigger in the main group than in the comparison one (p<0.01). The diameters of all the large cervical arteries were bigger in the main group (p<0.01). Therefore, according to the above-mentioned indices which are associated with a bigger risk of cerebrovascular events, a bigger hemodynamic load on the intracranial arterial system was found in the main group than in the comparison one, despite the smaller mean systolic blood pressure indices.
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