Arterial compression of the retro-olivary sulcus of the ventrolateral medulla in essential hypertension and diabetes.
Arterial compression of the retro-olivary sulcus of the ventrolateral medulla in essential hypertension and diabetes.
复制标题
原发性高血压和糖尿病患者腹外侧髓质橄榄后沟的动脉受压。
DOI：
10.1161/01.hyp.0000174617.09146.d4
复制
发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Patel,SunilJ
中科院分区：
文献类型：
--
作者：
Nicholas,JoyceS;D'Agostino,SabinoJ;Patel,SunilJ
沿腹外侧髓质表面橄榄后沟的脉动性动脉压迫被认为是原发性高血压和糖尿病的一种机制。本研究的目的是测试动脉压迫后橄榄沟对这些疾病的独立影响，使用单独的逻辑回归模型来控制其他已知的危险因素。研究设计为病例对照。研究人群包括147名连续接受神经系统疾病治疗的患者，需要对后颅窝进行MRI检查。从医疗记录中提取原发性高血压、糖尿病和每种疾病的危险因素的信息。动脉压迫的存在是通过磁共振图像的盲法检查来确定的。在原发性高血压分析中，在控制了年龄、体重指数、种族、糖尿病、高血压家族史等高血压危险因素后，高血压患者发生动脉压迫的几率是正常患者的2.99倍（P=0.04）。受压性高血压患者中，左侧受压56%，右侧受压44%。在糖尿病分析中，糖尿病患者发生动脉压迫的几率是非糖尿病患者的1.14倍（P=0.83）。在受压型糖尿病患者中，60%受压于左侧，40%受压于右侧。结果表明，动脉压迫橄榄后沟可能是该人群原发性高血压的独立危险因素，支持原发性高血压可治疗（微血管减压）神经机制的假设。然而，在糖尿病人群中，动脉压迫几率的轻微增加并不显著。
Pulsatile arterial compression in the retro-olivary sulcus along the surface of the ventrolateral medulla has been postulated as a mechanism in both essential hypertension and diabetes. The objective of this study was to test the independent effect of arterial compression in the retro-olivary sulcus on each of these diseases, using separate logistic regression models to control for other known risk factors. Study design was case–control. The study population consisted of 147 consecutive patients treated for neurological conditions requiring MRI of the posterior cranial fossa. Information on essential hypertension, diabetes, and risk factors for each disease was abstracted from medical records. Presence of arterial compression was determined by blinded review of magnetic resonance images. In the essential hypertension analysis, odds of arterial compression among hypertensive patients were 2.99-times the odds among normotensive subjects (P=0.04), controlling for hypertension risk factors such as age, body mass index, race, diabetes, and family history of hypertension. Of compressed hypertensive subjects, 56% were compressed on the left and 44% were compressed on the right. In the diabetes analysis, odds of arterial compression among diabetic subjects were 1.14-times the odds among nondiabetic subjects (P=0.83). Of compressed diabetic subjects, 60% were compressed on the left, and 40% were compressed on the right. Results suggest that arterial compression of the retro-olivary sulcus may be an independent risk factor for essential hypertension in this population, supporting the postulate for a treatable (with microvascular decompression) neural mechanism for essential hypertension. However, in the diabetic population, the slight increase in the odds of arterial compression was not significant.