高血压患者治疗前后肱-踝脉搏波传导速度和内皮微颗粒的变化  

Changes of pulse wave velocities and endothelial micro-particles in patients with stage 1 essential hypertension before and after treatment

作　　者：陈希伟 罗景云 韦建瑞[1,2] 吴同果 林梓卿[1,2] 关信民 朱媛[1,2] 刘江波 

机构地区：[1]广州市红十字会医院 [2]暨南大学医学院第四附属医院心血管内科,广州510220

出　　处：《岭南心血管病杂志》2012年第1期25-29,共5页South China Journal of Cardiovascular Diseases

基　　金：广州市医药卫生科技项目(项目编号:201102A213168)

摘　　要：目的观察1级原发性高血压(高血压)患者治疗前后肱踝脉搏波传导速度(brachial-ankle pulse wavevelocities,baPWV)和血浆内皮微颗粒(endothelial micro-particles,EMPs)变化的规律及意义。方法入选高血压1级患者63例,给予降压药物治疗后,观察患者治疗前,治疗后30、60、120 d的血压、baPWV和EMPs水平及血清内皮素-1、高敏C反应蛋白、白细胞介素-6、一氧化氮浓度。结果63例高血压1级患者治疗前后在体质量指数、总胆固醇等指标上比较,差异无统计学意义(P>0.05)。经过高血压药物治疗后,患者收缩压、舒张压、循环EMPs水平、baPWV水平及血清内皮素-1、高敏C反应蛋白、白细胞介素-6、一氧化氮浓度均较治疗前明显下降,差异有统计学意义(P<0.01);治疗后患者血清一氧化氮浓度升高,差异有统计学意义(P<0.01)。患者baPWV及lg-EMPs与收缩压(r=0.846,0.597;P<0.001)、舒张压(r=0.619,0.428;P<0.001)及血清内皮素-1(r=0.803,0.454;P<0.001)、高敏C反应蛋白(r=0.801,0.569;P<0.001)、白细胞介素-6(r=0.844,0.567;P<0.001)浓度呈正相关,与一氧化氮浓度呈负相关(r=-0.482,-0.127;P<0.001)。患者baPWV与lg-EMPs呈正相关(r=0.583,P<0.001)。结论在1级高血压患者中开展baPWV监测对于评估及预防动脉粥样硬化进程具有重要的临床意义及价值。Objectives To observe the changes of braehial-ankle pulse wave velocities （baPWV） and plasma endothelial micro-particles （EMPs） in patients with stage 1 essential hypertension before and after treatment. Methods Sixty-three patients with stage 1 hypertension were enrolled into the study. BaPWV, plasma EMPs, serum concentrations of endothelin （ET-1）, high sensitively C reactive protein （HsCRP）, interleukin-6 （IL-6） and nitrogen monoxide （NO） were measured pre-therapy and at 30 days, 60 days, 120 days post-therapy. Results There were no significent difference in body mass index, total cholesterol and the orther indexes of 63 patients with stage 1 hypertension before and after treatment （P〉0.05）. Systolic pressure, diastolic pressure, plasm EMPs level, baPWV level and serum concentrations of ET-1, HsCRP, IL-6 in patients significantly dreceased after treatment of hypertension drugs （P〈0.01）. While concentration of NO significantly increase after treatment （P〈0.01）. BaPWV and lg-EMPs postively correlated with systolic pressure （r=0.846, 0.597 ; P〈0.001 ）, diastolic pressure （r=0.619, 0.428 ;P〈0.001 ）, ET-1 （r =0.803, 0.454 ; P〈0.001 ）, HsCRP （r=0.801,0.569 ;P〈0.001 ）, IL-6 （r=0.844,0.567 ; P〈0.001 ）. BaPWV and lg- EMPs negatively correlated with NO （r =-0.482,-0.127 ;P〈0.001 ）. BaPWV postively correlated lg-EMPs （r=0.583, P〈0.001 ）. Conclusions Monitoring baPWV plays an important clinical role in evaluating and preventing the process of atherosclerosis in patients with stage 1 essential hypertension.

关 键 词：高血压 动脉粥样硬化 脉搏波传导速度 循环内皮微颗粒 

分 类 号：R544.1[医药卫生—心血管疾病]