高血压前期青年血管内皮功能障碍及其影响因素  

Endothelial dysfunction in young pre-hypertension and its influencing factors

作　　者：王兰[1,2] 牟建军[1] 杨睿海[3] 杨军[3] 王曼[1] 褚超[1] 谢冰清[1] 董珍珍[1] 

机构地区：[1]西安交通大学第一附属医院心内科,陕西西安710061 [2]3201医院心内科,陕西汉中723000 [3]汉中市人民医院心血管病研究所,陕西汉中723000

出　　处：《西安交通大学学报（医学版）》2017年第4期574-578,F0003,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：目的探讨社区高血压前期青年血管内皮功能障碍及其影响因素。方法以373名青年作为研究对象,依据血压水平将研究对象分为高血压组(HBP组),高血压前期组(PHT组)和正常血压组(NBP组)。以颈动脉内膜中层厚度(IMT)、血流介导的肱动脉扩张性(FMD)以及肱踝动脉脉搏波传导速度(baPWV)评估血管内皮功能。结果PHT组的IMT、baPWV值均高于NBP组(P均<0.05),但与HBP组间无统计学差异(P均>0.05)。PHT组的FMD水平高于HBP组(P<0.05),但与NBP组间比较无统计学意义(P>0.05)。高血压前期青年中,舒张压(β=-0.120,P<0.05)、体质量指数(β=-0.115,P<0.05)与FMD呈独立负相关;舒张压(β=0.146,P<0.05)、餐后2h血糖(β=0.147,P<0.05)、高密度脂蛋白胆固醇(β=0.150,P<0.05)、腰臀比(β=0.126,P<0.05)与IMT呈显著正相关;收缩压(β=0.358,P<0.01)、腰围(β=0.254,P<0.05)、空腹血糖(β=0.155,P<0.05)、餐后2h血糖(β=0.152,P<0.05)、血尿酸(β=0.206,P<0.05)以及超敏C反应蛋白(β=0.099,P<0.05)与baPWV相关。结论高血压前期青年已存在血管内皮功能障碍,多种心血管危险因素在高血压前期血管内皮功能障碍的发生发展中发挥重要作用。Objective To investigate the endothelial dysfunction in pre-hypertension and its influencing factors. Methods A total of 373 youth were divided as the subjects into hypertension group （HBP group）, pre- hypertension group （PHT group） and normal blood pressure group （NBP group）. Endothelial function was assessed based on carotid intima-media thickness （IMT）, brachial artery flow-mediated dilation （FMD） and brachial-ankle pulse wave velocity （baPWV）. Results IMT and baPWV in PHT group were higher than those in NBP group （P〈0.05）, but did not reach the significant difference when compared with HBP group （P〈 0.05）. Compared with HBP, the levels of FMD in PHT group significantly increased （P〈 0. 05）; however, no difference was observed in comparison with NBP group （P〉0.05）. In the early stage of hypertension, diastolic BP （β=0. 120, P〈0.05） and body mass index （β= -0. 115, P〈0.05） were negatively correlated with FMD; diastolic BP （β= 0. 146, P〈0.05）, 2-hour glucose （β=0. 147, P〈0.05）, high-density lipoprotein cholestrol （β=0. 150, P〈0.05）, and waist-hip ratio （β= 0. 126, P〈0.05） showed a positive correlation with IMT. baPWV was correlated with systolic BP （β=0.358, P〈0.01）, waist circumference （β=0.254, P〈0.05）, fasting glucose （β=0.155, P〈0.05）, postprandial 2 h blood glucose （β=0.152, P%0.05）, uric acid （β=0.206, P〈0.05）, and C-reactive protein （β= 0. 099, P〈0.05）. Conclusion Our study shows that endothelial dysfunction may exist in the pre- hypertensive young, and several cardiovascular risks contribute to its development in the early stage of hypertension.

关 键 词：高血压前期 血管内皮功能障碍 影响因素 青年 

分 类 号：R544.1[医药卫生—心血管疾病]