Gariepy J, Massonneau M, Levenson J, Heudes D, Simon A
Centre de Médecine Préventive Cardio-vasculaire, INSERM U 28, Paris, France.
Hypertension. 1993 Jul;22(1):111-8. doi: 10.1161/01.hyp.22.1.111.
Little is known of the in vivo structural changes of large arteries in uncomplicated hypertension. Therefore, we measured the intima-media thickness and lumen diameter of common carotid and femoral arteries by a computerized ultrasonographic technique in 25 normotensive and 25 never treated hypertensive men of similar age (from 25 to 72 years). The intraobserver variability of carotid and femoral wall thicknesses was 4.3% and 5.6%, respectively. Moreover, an in vitro study of 13 human arterial segments removed at autopsy demonstrated a strong correlation (r = .989, P < .001) between computerized ultrasonic and histological intima-media thickness measurements. Compared with control subjects, hypertensive patients had similar arterial diameters but higher carotid and femoral intima-media thicknesses (P < .001) as well as higher ratios of carotid and femoral intima-media thickness to lumen (P < .001, P < .01). The carotid thickness was correlated with age in control subjects (r = .48, P < .05) but not in hypertensive patients. The femoral thickness was correlated with age both in control subjects (r = .55, P < .01) and in hypertensive patients (r = .46, P < .05). Thus, carotid and femoral arterial walls of hypertensive patients were thickened. This thickening was not due to age, although aging also thickened both vessels in control subjects and the femoral artery only in hypertensive patients. Such a wall thickening associated with a normal diameter provides direct evidence of vascular growth and represents a new target to monitor noninvasively in vivo for large artery changes in human hypertension.
对于单纯性高血压患者体内大动脉的结构变化，我们所知甚少。因此，我们采用计算机超声技术测量了25名血压正常和25名未经治疗的年龄相仿（25至72岁）的男性高血压患者的颈总动脉和股动脉的内膜中层厚度及管腔直径。观察者间颈总动脉和股动脉壁厚度的变异性分别为4.3%和5.6%。此外，对13例尸检时切除的人体动脉节段进行的体外研究表明，计算机超声测量与组织学测量的内膜中层厚度之间存在很强的相关性（r = 0.989，P < 0.001）。与对照组相比，高血压患者的动脉直径相似，但颈总动脉和股动脉的内膜中层厚度更高（P < 0.001），颈总动脉和股动脉内膜中层厚度与管腔直径的比值也更高（P < 0.001，P < 0.01）。在对照组中，颈总动脉厚度与年龄相关（r = 0.48，P < 0.05），但在高血压患者中无此相关性。在对照组和高血压患者中，股动脉厚度均与年龄相关（对照组中r = 0.55，P < 0.01；高血压患者中r = 0.46，P < 0.05）。因此，高血压患者的颈总动脉和股动脉壁增厚。这种增厚并非由年龄引起，尽管衰老也会使对照组的这两种血管以及高血压患者的股动脉增厚。这种与正常直径相关的血管壁增厚为血管生长提供了直接证据，代表了一个在体内对人类高血压大动脉变化进行无创监测的新靶点。
