Abstract: Objective　To investigate the clinical outcome of carotid plaque in patients with satisfactory hypertension control in Guangzhou communities. Methods　From January 2016 to December 2019, 326 patients in Guangzhou communities were continuously recruited in the study, they were hospitalized in Department of Neurology, The First Affiliated Hospital of Guangzhou Medical University and also underwent carotid ultrasonography twice within half a year to one year. There were 166 males and 160 females, aged (71.17±0.60) years. The patients were divided into a non-hypertension group (NH group, 56 cases), a satisfactory hypertension control group (SH group, 195 cases), and an unsatisfactory hypertension control group (USH group, 75 cases). The clinical outcomes of carotid plaque (△Crouse score) of the three groups were compared. Then, a stratified analysis of △Crouse score was performed between younger than and equal to or older than 70 years old among the above three groups. Finally, the hypertensive patients were further subdivided into three subgroups of hypertension with satisfactory control twice (160 cases), satisfactory control once (35 cases), and unsatisfactory control twice (75 cases) to analyze the △Crouse score. The measurement data were tested by one-way ANOVA or Kruskal-Wallis method, and the count data were tested by χ² test. Results　There was no statistically significant difference in the △Crouse score between the SH group and the NH group (P>0.05); there was a statistically significant difference in the △Crouse score between the USH group and the SH group or the NH group [0.400 (0.000, 1.900 ) points vs. 0.000 (-0.200, 0.700) points vs. 0.000 (-0.200, 0.200) points] (both P<0.05). There were no statistically significant differences in the △Crouse score between the SH group and the NH group in patients younger than and equal to or older than 70 years old (both P>0.05). Among the three hypertensive subgroups, there was statistically significant difference in the △Crouse score between the two subgroups with and without satisfactory hypertension control twice (P<0.05), but there was no statistically significant difference between other subgroups (P>0.05). Conclusions　For hypertensive patients of all ages, after satisfactory hypertension control, the progression of carotid plaque is not significantly different from that of non-hypertensive patients. However, it is significantly accelerated in patients with unsatisfactory hypertension control.

Key words: Hypertension, Carotid plaque, Carotid ultrasonography, Community research

摘要： 目的　探讨广州社区高血压控制满意患者颈动脉斑块的临床转归。方法　连续收集2016年1月至2019年12月在广州医科大学附属第一医院神经内科在半年至1年内两次住院且均作颈动脉超声检测的广州社区患者326例，其中男166例、女160例，年龄（71.17±0.60）岁。分为非高血压（56例）、高血压控制满意（195例）和高血压控制不满意（75例）3组，比较颈动脉斑块的临床转归（△Crouse评分）；再将资料分为70岁以下和70岁及以上两个层次进一步分析3组间斑块的转归；最后，将高血压患者再分为高血压两次控制满意（160例）、一次控制满意（35例）和两次控制均不满意（75例）3个亚组，分析斑块的转归情况。计量资料采用单因素ANOVA或Kruskal-Wallis法检验，计数资料采用χ²检验。结果　高血压控制满意组和非高血压组间△Crouse评分差异无统计学意义（P>0.05）；但高血压控制不满意组与高血压控制满意组、非高血压组之间△Crouse评分差异均有统计学意义［0.400（0.000，1.900）分比0.000（-0.200，0.700）分比0.000（-0.200，0.200）分］（均P<0.05）。在70岁以下和70岁及以上患者中高血压控制满意患者与非高血压患者间△Crouse评分差异均无统计学意义（均P>0.05）。3个高血压亚组中，高血压两次控制满意组与两次控制不满意组间△Crouse评分差异有统计学意义（P<0.05），其他分组间差异无统计学意义（P>0.05）。结论　对所有年龄的高血压患者，血压控制满意后，颈动脉斑块进展情况与非高血压患者无明显差别；但血压控制不满意患者颈动脉斑块的进展明显增快。

关键词: 高血压, 颈动脉斑块, 颈动脉超声, 社区研究