[摘要]  目的 探讨原发性高血压患者血压分级以及危险因素分层与动脉脉搏波速度（PWV）的关系。 方法 应用动脉脉搏波速度（PWV）自动测量系统测定入选的560例原发性高血压患者的肱动脉-踝动脉PWV（baPWV）值，并对患者进行危险因素分层，比较不同血压水平及危险程度患者的脉搏波速度。结果 1级与2级高血压患者的baPWV差异无统计学意义[(1540±150) cm/s 比. （1630±160） cm/s,  P=0.298]；伴有一种以上心血管危险因素者的baPWV显著高于单纯高血压患者[（1645±138） cm/s比. (1584±160) cm/s, P＝0.001)。结论 存在一种或一种以上心血管危险因素的高血压患者PWV值明显高于无危险因素的高血压患者，心血管危险因素对脉搏波速度的影响可能较大。

　　　
      Analysis of the relationship between pulse wave velocity, blood pressure and cardiovascular risk factors in patients with essential hypertension. XIANG Xiao -ping , NING Xin-hui, ZHOU Zhe, YUAN Han-yin, LIU Yu, WANG Wen-jun, Department of Cardiology, the Sixth Hospital of Beijing,  100007; Hu Da-yi, Department of Cardiology,the People’s Hospital of Beijing University,100044.
　　[Abstract]   Objective  To explore the relationship between pulse wave velocity (PWV), blood pressure and cardiovascular risk factors in patients with essential hypertension. Methods We included 560 continuous patients with essential hypertension and measured brachial-ankle PWV in each patient by using automatic pulse wave velocity measurement system. The classical cardiovascular risk factors of each patient were also recorded. The baPWVs were compared among patients with different blood pressures and with/without cardiovascular risk factors. Results There was no significant difference of baPWVs between grade 1 and grade 2 hypertensives (1540±150 m/s vs. 1630±160 m/s, P = 0.298). The PWV in patients with more than one risk factor was significantly higher than that in patients with hypertension alone (1645±138 cm/s vs. 1584±160 cm/s, P = 0.001). Conclusion baPWV increased significantly in hypertensive patients with over one cardiovascular risk factor, and cardiovascular risk factor might play a more important role in arterial stiffness.
      [Key wards]  Hypertension; pulse wave velocity; Risk factor　　
　　脉搏波速度增加已经被大量流行病学研究和临床试验证实是一项独立的心血管危险因素[1]。脉搏波速度（pulse wave velocity，PWV）是评价动脉僵硬度的经典指标。目前动脉弹性的研究多集中在收缩压以及脉压对其影响上，对于心血管危险因素对大动脉弹性影响的研究报道较少。有研究认为心血管危险因素与baPWV密切相关[2,3]。我们应用日本科林VP-1000全自动动脉硬化检测仪对560例高血压患者的大动脉弹性进行检测，探讨血压水平以及高血压是否合并有其他危险因素对大动脉僵硬度的影响。
　　　　　　　　　　　　　　　　对象和方法
      1．对象：研究入选了从2005年1月至2006年8月就诊于北京市第六医院内科门诊和病房的560例原发性高血压患者，包括从未治疗的高血压患者及正在接受药物治疗但停用降压药5个半衰期的高血压患者，同时剔除继发性高血压患者。血压分级采用JNC7[4]的标准。心血管危险因素包括：吸烟、血脂异常、肥胖、血糖异常或糖耐量异常、颈动脉粥样硬化、高血压家族史和早发冠心病家族史。
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