目的:研究老年单纯收缩期高血压不同中医证候之间肾动脉血流动力学的关系。方法 :纳入100例单纯收缩期高血压患者,平均年龄77.49岁,根据中医辨证分型分为肾气亏虚证、痰瘀互结证、肝火亢盛证、阴虚阳亢证四组,用彩色多普勒超声分别获取主肾动脉(MRA)、段动脉(SRA)和叶间动脉(IRA)的收缩期血流峰值速度(Vmax)、舒张末期低值血流速度(Vmin)、阻力指数(RI)及搏动指数(PI),进行统计学分析。结果:(1)各级肾动脉的Vmax、Vmin、RI、PI的组间比较差异均具有统计学意义(P<0.05);(2)肾气亏虚证组各级肾动脉的Vmax与Vmin小于其他分组(P<0.05);肾气亏虚证组各级肾动脉的RI与PI大于其他分组(P<0.05)。结论:肾气亏虚证老年单纯收缩期高血压患者较其他证型更易发生早期肾损害的血流动力学改变。

Objective:To study the correlation between renal artery hemodynamics of elderly systolic hypertension and traditional Chinese medicine(TCM) syndrome types. Methods:One hundred patients with isolated systolic hypertension were included,with an average age of 77.49 years. According to TCM syndrome differentiation,they were divided into four groups:kidney qi deficiency syndrome,binding of phlegm and blood stasis syndrome,liver qi stagnation syndrome,and yin deficiency with yang hyperactivity syndrome. Color Doppler sonography was performed to measure the systolic blood flow peak velocity(Vmax),end-diastolic blood flow velocity(Vmin),and resistance index(RI) of the main renal artery(MRA),segmental artery(SRA),interleaf artery(IRA),and pulsatility index(PI). Statistical analysis was performed. Results:(1)There were differences of Vmax,Vmin,RI and PI between the renal arteries of all levels,with statistically significance(P<0.05).(2)The Vmax and Vmin of renal arteries at all levels in the kidney qi deficiency syndrome group were smaller than other groups(P<0.05);RI and PI of renal arteries in all groups in the kidney qi deficiency syndrome group were greater than other groups(P<0.05). Conclusion:In renal artery hemodynamics of elderly systolic hypertension of kidney qi deficiency type it is more likely to have hemodynamic changes in early renal damage than in other types.