论文部分内容阅读
该研究入选动脉疾病继发表现磁共振研究(SMART-MR)中的动脉粥样硬化患者575例,探索高血压、血压、降压药物与实质脑血流量(pCBF)变化的纵向相关性。在基线和随访过程中用磁共振血管造影测定脑血流量,以每100mL脑容积的脑血流量作为脑灌注的指标。基线pCBF为(52.3±9.8)mL/(min.100mL),随访3.9(3.0～5.8)年后减少至(50.7±10.3)mL/(min.100mL)。调整年龄、性别、随访时间和血管风险后,回归分析表明未经治疗和控制不良的高血压、较高水平的收缩压和舒张压与pCBF下降明显相关。此外,在高血压患者中(n=469),使用血管紧张素受体拮抗剂(ARB)患者的pCBF几乎不变,而使用其他降压药物的患者pCBF下降。总之,未经治疗和控制不良的高血压、高收缩压和舒张压与pCBF下降明显相关,使用ARB较使用其他降压药物者pCBF下降程度较小。
This study enrolled 575 patients with atherosclerosis in the Secondary Performance Magnetic Resonance Study of Arterial Disease (SMART-MR) to explore the longitudinal association of hypertension, blood pressure, antihypertensive drugs with change in real cerebral blood flow (pCBF). Cerebral blood flow was measured by magnetic resonance angiography at baseline and during follow-up. Cerebral blood flow per 100 mL brain volume was used as an index of cerebral perfusion. Baseline pCBF was (52.3 ± 9.8) mL / (min.100 mL) and decreased to (50.7 ± 10.3) mL / (min.100 mL) after 3.9 (3.0-5.8) years of follow-up. After adjustment for age, gender, follow-up time, and vascular risk, regression analysis showed that untreated and poorly controlled hypertension, higher levels of systolic and diastolic pressures were significantly associated with decreased pCBF. In addition, pCBF was almost unchanged in patients with hypertension (n = 469) using angiotensin receptor blockers (ARB), whereas patients with other antihypertensive drugs showed decreased pCBF. In conclusion, untreated and poorly controlled hypertension, high systolic and diastolic blood pressure were significantly associated with a decrease in pCBF, with a slight decrease in pCBF with ARB compared with other antihypertensive agents.