Laurent S, Lacolley P, Girerd X, Caviezel B, Beck L, Challande P, Safar M
Service de pharmacologie, hôpital Broussais, Paris.
Arch Mal Coeur Vaiss. 1994 Aug;87(8):1069-72.
Whether the decrease in large artery compliance, observed in hypertensive patients (HT), is due to an increase in distending pressure or to intrinsic alterations of the vascular wall remains much debated. We determined the diameter-pressure curve of the common carotid artery over the systolic-diastolic range, then derived the compliance-pressure curve, in order to compare arterial compliance in normotensive subject (NT) and in HT, for a common level of distending blood pressure: 100 mmHg (isobaric compliance). Fourteen NT and 15 never treated essential HT were included in the study. The diameter-pressure curve of the common carotid artery was determined non-invasively by simultaneously and continuously recording the systolic-diastolic changes in internal diameter (using a high resolution echotracking system) and pressure waveform (using high fidelity applanation tonometry on the contralateral artery) over 4-6 cardiac cycles. The level of MAP of the carotid pressure waveform was determined electronically and set equal to mean brachial pressure. Compliance-pressure curve was then derived from the pressure-diameter curve in order to determine compliance (C) for any given level of blood pressure, particularly MAP (CMAP) and 100 mmHg (C100). Despite the considerable differences in blood pressure, the compliance-pressure curve of HT was not different from that of NT. CMAP decreased with aging (p < 0.001) and MAP (p < 0.001). According to age, CMAP was reduced in HT as compared to NT (84 +/- 49 vs 116 +/- 52 mm2.mmHg.10(-3) p < 0.01). C100 decreased with aging (p < 0.05) but not with MAP. According to age, C100 was not reduced in hypertensives.(ABSTRACT TRUNCATED AT 250 WORDS)
高血压患者（HT）中观察到的大动脉顺应性降低是由于扩张压力增加还是血管壁的内在改变，这一问题仍存在诸多争议。我们测定了颈总动脉在收缩 - 舒张范围内的直径 - 压力曲线，然后得出顺应性 - 压力曲线，以便在相同的扩张血压水平（100 mmHg，等压顺应性）下比较正常血压受试者（NT）和高血压患者的动脉顺应性。14名正常血压受试者和15名未经治疗的原发性高血压患者纳入了本研究。通过在4 - 6个心动周期内同时连续记录内径的收缩 - 舒张变化（使用高分辨率超声跟踪系统）和压力波形（使用对侧动脉的高保真压平式眼压计），非侵入性地测定颈总动脉的直径 - 压力曲线。通过电子方式确定颈动脉压力波形的平均动脉压（MAP）水平，并使其等于肱动脉平均压。然后从压力 - 直径曲线得出顺应性 - 压力曲线，以确定任何给定血压水平下的顺应性（C），特别是MAP（CMAP）和100 mmHg（C100）时的顺应性。尽管血压存在显著差异，但高血压患者的顺应性 - 压力曲线与正常血压受试者并无不同。CMAP随年龄增长而降低（p < 0.001），并与MAP有关（p < 0.001）。根据年龄，与正常血压受试者相比，高血压患者的CMAP降低（84±49 vs 116±52 mm2.mmHg.10(-3)，p < 0.01）。C100随年龄增长而降低（p < 0.05），但与MAP无关。根据年龄，高血压患者的C100并未降低。（摘要截取自250字）
