原发高血压患者动态脉压与大动脉弹性及血管内皮功能的关系(英文)  

Correlations of ambulatory pulse pressure to large artery elasticity and vascular endothelial function in patients with primary hypertension

作　　者：杜大勇[1] 李运田[1] 王红宇[2] 丁康[1] 李艳[1] 

机构地区：[1]解放军第三O五医院冠心病诊疗中心,北京市100013 [2]北京大学人民医院心内科,北京市100044

出　　处：《中国组织工程研究与临床康复》2008年第7期1363-1367,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：全军“十一五”科技攻关项目支助(06G145)~~

摘　　要：背景：动态血压监测能较敏感、客观的反映实际血压水平，与靶器官损害及预后的关系密切。高血压靶器官损害中以血管内皮损害最常见。动态血压与大动脉弹性及血管内皮功能变化是否有一定相关性？目的：应用自动脉搏波速度测定仪和超声技术评价原发高血压患者大动脉弹性和内皮功能的变化，分析患者动态脉压与大动脉弹性、内皮功能的关系。设计：非随机化同期对照临床观察。单位：解放军第三0五医院冠心病诊疗中心。对象：选择2005-06／2007—04在解放军第三0五医院冠心病诊疗中心门诊和住院156例新近诊断原发性高血压患者，男114例，女42例，年龄40～75岁，平均（56±4）岁。纳入标准：①符合2004年中国高血压防治指南诊断标准。②近1月内在门诊或住院诊断原发高血压。③未服任何降压、降脂以及硝酸酯类药物治疗。患者均对检测知情同意，实验经过医院伦理委员会批准。方法：①实验分组：根据24h平均脉压水平将患者分为3组：24h脉压〈40mmHg组（n=92），40mmHg≤24h脉压〈60mmHg组（n=39）及24h脉压≥60mmlHg组（n=25）。②项目检测：采用美国Meditech公司ABPM-04无创性携带式动态血压监护仪检测各组患者白昼及夜间脉压及24h平均脉压；应用自动脉搏波速度测定仪测定颈-股动脉脉搏波速度和颈-桡动脉脉搏波速度评价大动脉扩张性；应用高分辨率血管外超声分别通过对肱动脉进行血流介导的血管扩张和硝酸甘油依赖性的血管扩张测定来评价内皮功能。主要观察指标：患者动态脉压与大动脉扩张性及动脉内皮功能的相关性。结果：纳入患者156例均进入结果分析。①动态脉压与大动脉扩张性的相关分析：颈-桡动脉脉搏波速度与白昼脉压、夜间脉压及24h平均脉压均呈显著正相关，偏相关系数分别为0．310、0．281和0．303（P均〈0.01），颈-�BACKGROUND： Ambulatory blood pressure monitoring can sensitively and objectively reflect blood pressure level, which is closely related to target organ damage and disease prognosis. In hypertension, vascular endothelial damage is the most common lesion to target organs. There is little known about how ambulatory pulse pressure correlates to large artery elasticity and vascular endothelial function. OBJECTIVE： To investigate changes of large artery elasticity and of vascular endothelial function in patients with primary hypertension using an automatic pulse wave velocity determinator and ultrasound techniques, and to analyze the correlation of ambulatory pulse pressure to large artery elasticity and vascular endothelial function. DESIGN： A non-randomized concurrent control clinical observation. SETTING： Diagnosis and Treatment Center for Coronary Heart Disease, the 305 Hospital of Chinese PLA. PARTICIPANTS： A total of 156 inpatients and/or outpatients, who were recently confirmed with primary hypertension, were recruited for this study between June 2005 and April 2007. Patients consisted of 114 males and 42 females. All patients averaged 56 ± 4 years of age （range： 40 75）. Inclusive criteria： Corresponding to diagnostic standards for preventing and treating hypertension instituted in 2004 by Chinese scholars. Confirmed as primary hypertension within 1 month. Not receiving any blood pressure lowering, hypolipidemic or nitrate-like drug treatments. Written informed consents for laboratory measurements were obtained from all subjects. The study was approved by the hospital＇s Ethics Committee. METHODS： According to the mean pulse pressure over 24 hours, all patients were assigned into 3 groups： Group A （mean pulse pressure 〈 40 mm Hg, n=92）, group B （40 mm Hg ≤ mean pulse pressure 〈 60 mm Hg, n=39） and group C （mean pulse pressure 〉 60 mm Hg, n=25）. In each group, daytime pulse pressure and night-time pulse pressure, as well as 24-hour mean pulse pressure were mea

关 键 词：高血压 脉压 大动脉弹性 内皮功能 组织构建 

分 类 号：R544.1[医药卫生—心血管疾病]