高血压患者脉压与肱动脉内皮依赖性血管舒张功能及颈动脉内—中膜厚度关系的研究  

Relationship of Pulse Pressure With Brachial Artery Endothelium-Dependent Vasodilation Function and Carotid Intima-Media Thickness of the Hypertension Patients

作　　者：孙妍[1] 王国干[1] 关键[1] 朱俊[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院急症抢救中心

出　　处：《中国循环杂志》2007年第4期253-256,共4页Chinese Circulation Journal

摘　　要：目的:研究原发性高血压(高血压)患者脉压与肱动脉血流介导的内皮依赖性血管舒张功能(FMD)及颈动脉内—中膜厚度的关系。方法:选择高血压患者52例,按脉压频数分布分为两组,脉压<50mmHg组(n=28例),脉压≥50mmHg组(n=24例)。另选(健康体检者)正常对照组21例。用高分辨率超声检测各组颈动脉内—中膜厚度、FMD、硝酸甘油介导的非内皮依赖性血管舒张功能(NID),并进行统计学分析。结果:①各组FMD变化:正常对照组为(8.85±5.08)%,脉压<50mmHg组为(5.45±4.08)%,脉压≥50mmHg组为(2.21±2.97)%,3组间两两比较均有极显著性差异(P<0.01)。②各组NID变化:正常对照组为(15.86±5.27)%,脉压<50mmHg组为(13.97±7.21)%,脉压≥50mmHg组为(10.65±4.26)%,3组间两两比较均无显著性差异(P>0.05)。③FMD及NID与其它因素的相关性分析:FMD与脉压呈负相关(r=-0.46,P<0.01);与收缩压呈负相关(r=-0.33,P<0.05);FMD随年龄增加降低,相关系数为r=-0.28,P<0.05。NID随脉压增加而降低,相关系数为r=-0.28,P<0.05。④各组颈动脉内—中膜厚度变化:与正常对照组[(0.74±0.24)mm]比较,脉压<50mmHg组[(1.00±0.21)mm]和脉压≥50mmHg组[(1.18±0.27)mm],均有极显著性差异(P=0.01);且脉压<50mmHg组与脉压≥50mmHg组比较,有显著性差异(P<0.05)。结论:高血压患者FMD、NID均较正常人减退,且高血压患者随脉压的增高FMD及NID均有不同程度的受损。脉压增高的高血压患者颈动脉内—中膜厚度增厚,且均较血压正常者增厚。Objective：This study was sought to investigate whether pulse pressure is associated with endothelium-dependent vasodilation in a group of hypertension patients. Methods：Fifty-two hypertension patients were categorized into 2 groups according to different PP：PP 〈 50 mmHg group（ n = 28 ）, PP PP〉50 mmHg group（ n = 24）, and 21 controls with normotension. Carotid arterial intima-media thickness （IMT）, endotheliurn-dependent and independent vasodilation were investigated by high-resolution vascular ultrasound. Results ①There was a significant difference in brachial artery flow-mediated dilation （FMD）between groups （5.45 ±4.08 ） % , （ 2.21± 2.97 ） % and（ 8.85± 5.08 ） % ,P = 0. 007. Nitroglycerin-induced dilatation between groups had no significant difference （ 3.97 ± 7.21 ） % , （ 10.65 ± 4. 26） % and （ 15.86 ± 5.27 ） % , P 〉 0.05. ②FMD was negatively correlated with PP（r = - 0.46 ,P 〈0.01 ）.③There was a significant difference in IMT between groups（ 1.00 ± 0.21 ） mm, （ 1.18 ± 0.27 ） mm and（0.74 ±0. 24） mm.P 〈0. 01. Conclusion：Our study indicated both endothelial and underlining smooth muscle functions were impaired to some degree in hypertension patients, Which were all decreased compared to the controls. In hypertension patients with increased pulse pressure tend to have an increased IMT.

关 键 词：脉压 内皮功能 高血压 

分 类 号：R541.2[医药卫生—心血管疾病]