动态动脉硬化指数与高血压靶器官损伤的相关性及动态观察

摘要

目的：通过对高血压患者降压治疗，观察动态动脉硬化指数（AASI）及靶器官损伤的变化，探讨AASI与靶器官损伤的相关性及动态改变。方法筛选300例初治高血压患者，严格控制血压后，随访1年完成动态血压及靶器官损伤的检查，观察AASI及靶器官损伤的动态变化。结果经过1年降压治疗后，AASI呈逐步下降趋势，与治疗前对比，第6个月出现下降，1年后出现显著下降；治疗前及治疗后AASI均与颈动脉内膜‐中层厚度（IMT）、尿微量清蛋白（UMA）、肾血管阻力指数（RRI）、左心室质量指数（LVMI）呈独立正相关，与内生肌酐清除率（Ccr）呈独立负相关；多元线性回归分析显示，IMT、UMA、RRI、Ccr、LV‐MI与AASI均有显著相关性。治疗1年后，IMT、UMA、RRI、Ccr及LVMI均得到改善（P＜0．05）。结论 AASI可以作为评估高血压动脉硬化和预测高血压靶器官损伤的指标。%Objective To observe the changes of ambulatory arterial stiffness index (AASI) and target organ damage (TODs) after antihypertensive treatment in hypertensive patients .Methods A total of 300 cases of newly diagnosed hypertension were screened out and after strictly controlling blood pressure ,completed the ambulatory blood pressure and target organ damage inspection by 1‐year follow‐up .The dynamic changes of AASI and target organ damage were observed .Results After 1‐year anti‐hypertensive therapy ,AASI showed the gradually descending trend ,compared with before treatment ,began to decline at 6 months , decreased significantly after 1 year ;AASI showed the independent positive correlation with the intima‐media thickness(IMT) of ca‐rotid artery ,urine microalbumin(UMA) ,renal vascular resistance index(RRI) and left ventricular mass index(LVMI) ,and inde‐pendent negative correlation with endogenous creatinine clearance rate(Ccr) before and after treatment ;the multiple linear regres‐sion analysis showed that IMT ,UMA ,RRI ,Ccr and LVMI had significant correlation with AASI .After 1 year of therapy ,IMT , UMA ,RRI ,Ccr ,LVMI had shown some improvement(P<0 .05) .Conclusion AASI can be used as an indicator for evaluating arte‐riosclerosis and predicting the target organ damage in hypertension .