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目的验证并比较高血压和高脂血症致颈动脉粥样硬化(carotid atherosderosis,CAS)作用,评价高血压在CAS发生中的重要意义。方法 2010年12月—2012年12月在仙桃市第一人民医院就诊的正常人群、高脂血症患者和高血压合并高脂血症患者各60例及高血压患者180例(1、2和3级高血压患者各60例)作为研究对象,应用彩色多普勒超声检测所有研究对象的颈动脉内—中膜厚度(intima-media thickness,IMT)和颈动脉粥样斑块的发生率。结果比较各组IMT值,高脂血症组、高血压合并高脂血症组及高血压组均明显高于正常对照组,差异有统计学意义(P<0.01);对各组颈动脉粥样斑块发生率进行比较,高脂血症组、高血压合并高脂血症组及高血压组也明显高于正常对照组,差异同样有统计学意义(P<0.01)。高脂血症组的IMT值和颈动脉粥样斑块发生率均高于高血压组,但差异无统计学意义(P>0.05)。1级高血压组的IMT值和颈动脉粥样斑块发生率与正常对照组比较,差异无统计学意义(P>0.05);2级高血压组的IMT值低于高脂血症组,差异有统计学意义(P<0.05);颈动脉粥样斑块发生率高于高脂血症组,但差异无统计学意义(P>0.05);3级高血压组的IMT值和颈动脉粥样斑块发生率均高于高脂血症组,差异有统计学意义(P<0.05)。结论高血压与高脂血症具有同等重要的致CAS作用,其中3级高血压的致CAS作用强于高胆固醇血症。良好地控制血压(尤其是3级高血压)对于临床减缓CAS进程及减少甚至避免CAS的发生有着比降血脂更加不容忽视的临床意义。
Objective To verify and compare the effects of carotid atheroscleosis (CAS) induced by hypertension and hyperlipidemia and to evaluate the significance of hypertension in the pathogenesis of CAS. Methods From December 2010 to December 2012, 60 normal subjects, 60 patients with hyperlipidemia and hyperlipidemia and 180 patients with hypertension were enrolled in the First People’s Hospital of Xiantao City (1, 2 and 60 patients with grade 3 hypertension) were included in this study. Color Doppler ultrasound was used to detect carotid artery intima-media thickness (IMT) and carotid artery plaque in all subjects. Results Compared IMT value, hyperlipidemia group, hypertension with hyperlipidemia group and hypertension group were significantly higher than the normal control group, the difference was statistically significant (P <0.01); carotid atherosclerosis The incidence of plaques was also significantly higher in hyperlipidemia group, hypertension with hyperlipidemia group and hypertension group than in normal control group (P <0.01). IMT and carotid plaque incidence in hyperlipidemia group were higher than those in hypertension group, but the difference was not statistically significant (P> 0.05). IMT and carotid plaque incidence in grade 1 hypertension group were not significantly different from those in control group (P> 0.05); IMT value in grade 2 hypertension group was lower than that in hyperlipidemia group (P <0.05). The incidence of carotid artery atherosclerotic plaque was higher than that of hyperlipidemia group, but the difference was not statistically significant (P> 0.05). The IMT and carotid artery The incidence of atherosclerotic plaque was higher than that of hyperlipidemia group, the difference was statistically significant (P <0.05). Conclusions Hypertension and hyperlipidemia have the same important role of CAS. The role of hypertension in CAS is stronger than that of hypercholesterolemia. Good blood pressure control (especially grade 3 hypertension) has clinical significance for clinical slowing down of CAS progression and reducing or even avoiding the occurrence of CAS, which can not be ignored more than lowering blood fat.