原发性高血压患者盐敏感性与血管重构的探讨  

Relationship between salt sensitivity and vascular remodeling in primary hypertensive patients

作　　者：胡咏梅[1] 刘小蓉[1] 赵思勤[1] 聂晓莉[1] 李秋[1] 王勉[1] 吴涛[1] 张文勇[1] 刘剑雄[1] 

机构地区：[1]成都市第二人民医院心内科,610017

出　　处：《中华老年心脑血管病杂志》2010年第7期590-592,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：四川省卫生厅科研项目(060162);成都市科技攻关计划(200630)

摘　　要：目的探讨原发性高血压患者盐敏感性与血管重构的关系。方法选择原发性高血压患者204例(高血压组),高血压组又分为:盐敏感性组96例和盐不敏感性组108例,另选46例健康体检者作为对照组。采用ELISA法测定血清血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF),超声测试肱动脉血流介导的血管舒张功能(FMD)和颈动脉内膜中层厚度(IMT)。结果高血压组患者尿酸、体重指数较对照组明显升高(P<0.01)。与盐不敏感性组比较,盐敏感性组患者LDL-C、尿酸明显升高,HDL-C明显下降(P<0.01)。高血压组患者VEGF、bFGF、IMT较对照组明显升高,FMD明显下降(P<0.01)。盐敏感性组患者VEGF、bFGF、IMT较盐不敏感性组进一步升高,FMD进一步下降(P<0.01)。回归分析显示,盐敏感性、TC、TG、lgVEGF是IMT独立预测指标,盐敏感性与IMT独立相关(r=0.534,P<0.01)。结论盐敏感性是高血压患者血管重构、靶器官损害的独立预测因素。Objective To investigate the relationship between salt sensitivity and vascular remodeling in hypertensive patients. Methods 204 mild to moderate hypertensive patients and 46 healthy people（control group） were recruited in this study. According to modified Sullivan＇s acute venous saline loading and furosemide volume-depletion tests,204 hypertensive patients were divided into salt-sensitive group（SS, n = 96） and non-salt-sensitive group（NSS, n = 108）. The serum concentrations of vascular endothelial growth factor（VEGF） and basic fibroblast growth factor（bFGF） were measured by ELISA assay. The flow mediated-dilatation（FMD） in brachial arteries in responding to reactive hyperemia and carotid intima-media thickness（IMT） were tested with highresolution ultrasound. Results Compared with the control group, serum uric acid and BMI were increased in hypertension group （P 〈0. 01）. Compared with NSS group, serum uric acid and LDL-C were higher,while HDL-C was lower in SS group （P 〈 0.01）. Compared with the control group,serum concentrations of VEGF, bFGF and IMT were increased, while FMD （P 〈 0. 01） was decreased in hypertensive patients. VEGF, IMT, bFGF were higher and FMD was lower in SS group than in NSS group （P 〈 0.01）. Multivariate regression analysis revealed that salt sensitivity,TC,TG,lgVEGF were independent predictors of IMT. IMT had independent correlation with salt sensitivity （r = 0. 534, P 〈 0.01）. Conclusion Salt sensivitity is an independent predictor for vascular remodeling and target organ damage in hypertensive petients.

关 键 词：高血压 血管内皮生长因子类 成纤维细胞生长因子2 尿酸 危险因素 盐敏感 血管重构 

分 类 号：R544.1[医药卫生—心血管疾病]