高血压病人阻力动脉重构和微血管功能障碍  

The Remodeling of Resistance Arteries and Its Microvessel Dysfunction in Hypertension

作　　者：骆秉铨[1] 韩冰[1] 林荣 赵爱亭 

机构地区：[1]江苏省徐州市第三人民医院心脏中心,221005 [2]江苏省徐州市心血管病研究所

出　　处：《中国微循环》2005年第6期414-416,共3页Journal of Chinese Microcirculation

摘　　要：目的研究原发性高血压(EH)阻力动脉重构及其微血管整合功能。方法对EH病人30例和正常对照组30例,采用上肢节段性血压、Dopp ler超声、激光Dopp ler血流仪等无创性检查方法,评估阻力动脉结构、功能和微循环变化。结果①EH病人阻力动脉段向上延伸(P<0.05),包括微动脉和小动脉;②阻力动脉重构特征:小动脉管壁增厚(P<0.01)、壁/腔比值增大(P<0.01),腔径轻度减少(P>0.05);管壁僵硬度增加,脉波传导速度增快(P<0.001);血流介导内皮依赖性血管扩张障碍和收缩作用减弱。③同时,皮肤毛细血管压升高(P<0.01),这与阻力动脉重构引起微循环“调节机制储备”受损和上游高血压跨壁传输作用的两种机制有关。结论高血压病人阻力动脉段向上延伸,伴存动脉结构、机械特性和血管舒缩运动异常,并导致微血管系统整合功能障碍。测定这些改变的相关指标,有助于评估微血管病变程度和降压治疗的外周效应。Objective To research the remodeling of resistance arteries and its effects of microvasctdature in patient with hypertension. Methods Thirty patients with essential hypertension（EH） and 30 normatension（NT） controls were selected. To assess properteies of structure, mechanic and function at resistance artery and its microciretdation measured by non - invasive methods. Results 1. There was extending upward at resistance arterial segment including small artery and arteriole in EH than in NT 2. Resistance arterial remodeling involves thickening of the vascular wall（ P 〈 0.01 ）, increased wall/lumen ratio（ P 〈 0.01） and slightly reduced lumen diameter （ P 〉 0.05）, which were associated with increased pulse wave velocity（PWV） at braehial - digital artery （ P 〈 0. 001） and a blood flow mediated endothelium - dependant vasomotion dysfunction. 3. Meanwhile there was an elevated capillary pressure, because of both changes of the microvessel dysfunction and the effect of pressure transmission at upstream arteries. Conclusion The resistance arteries extend upward, assosiated with vascular abnormalities of structure, mechanic and function and its microvessel dysfunction in EH. Measuring the resistance arteries related index would help to assess degree of microvessel disease and perpheral effects of antihypertensive therapy.

关 键 词：高血压 阻力动脉重构 微血管功能障碍 

分 类 号：R544.1[医药卫生—心血管疾病] R322.13[医药卫生—内科学]