原发性高血压患者不同盐敏感风险分层血流介导血管舒张功能的比较  

Comparison of flow-mediated vasodilation in different salt-sensitivity risk stratification in essential hypertensive patients

作　　者：祝艳秋[1] 郭立苹[1] 张英[2] 姜一农[2] 程云鹏[2] ZHU Yanqiu;GUO Liping;ZHANG Ying;JIANG Yinong;CHENG Yunpeng(Department of Ultrasonic,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China;Department of Cardiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China)

机构地区：[1]大连大学附属中山医院超声科,辽宁大连116001 [2]大连医科大学附属第一医院心内科,辽宁大连116011

出　　处：《大连医科大学学报》2018年第4期326-329,共4页Journal of Dalian Medical University

基　　金：辽宁省博士课题启动基金项目(201601228)

摘　　要：目的探讨原发性高血压患者不同盐敏感风险分层组血流介导的血管舒张功能(FMD)的变化。方法选择2017年2月至8月,大连医科大学附属第一医院高血压科住院的原发性高血压患者171例,根据动态血压中的24小时平均心率(24h HR)与夜间平均动脉压下降率(MAP_(NF)),将患者分为盐敏感低风险组(24h HR≤70次/min且MAP_(NF)>10%)、中风险组(24h HR>70次/min,MAP_(NF)>10%;或24h HR≤70次/min,MAP_(NF)≤10%)及高风险组(24h HR>70次/min且MAP_(NF)≤10%),比较各组间临床基本特征及FMD,探讨FMD与各因素的相关性。结果高风险组体质量指数(BMI)、24h HR显著高于低风险组与中风险组(均P<0.05),低密度脂蛋白胆固醇(LDL-C)显著高于中风险组,而MAP_(NF)显著低于中风险组与低风险组(均P<0.05);中风险组24h HR显著高于低风险组(P<0.05),而MAP_(NF)显著低于低风险组(P<0.05)。高风险组FMD显著低于中风险组与低风险组(均P<0.05);而中风险组FMD与低风险组无统计学差异(P>0.05)。FMD与24h HR呈负相关(β=-0.170,P=0.044),与MAP_(NF)呈正相关(β=0.223,P=0.007);而与BMI、LDLC无相关性(P>0.05)。结论高血压患者盐敏感性可能与血管内皮功能相关。Objective To investigate the changes of flow-mediated vasodilation（ FMD） in different salt-sensitivity risk stratification in essential hypertensive（ EH） patients. Methods Totally 171 hospitalized EH patients were recruited. All participants received ambulatory blood pressure monitoring（ ABPM）. According to the 24-h mean heart rate（ 24 h HR） and nocturnal fall of mean arterial pressure（ MAPNF） gained from ABPM,participants were divided into salt-sensitivity low risk group（ 24 h HR≤70 bpm,MAPNF〉 10%,LRG,n = 33）,intermediate risk group（ 24 h HR 〉70 bpm,MAPNF〉10%,or 24 h HR ≤ 70 bpm,MAPNF≤ 10%,IRG,n = 96） and high risk group（ 24 h HR〉 70 bpm,MAPNF≤ 10%,HRG,n = 42）. Background clinical data and FMD were compared among groups. And the correlation between FMD and clinical features were analyzed. Results The body mass index（ BMI）,24 h HR of HRG were significantly higher than LRG and IRG（ P〈0. 05）,but the MAP_（NF）and FMD were significantly lower than LRG and IRG（ P〈0. 05）. The BMI and 24 h HR of IRG were significantly higher than IRG（ P〈0. 05）,meanwhile,the MAP_（NF） and FMD were significantly lower than LRG（ P〈0. 05）. Multiple linear regression analysis showed that FMD was negatively correlated with 24 h HR（ β =-0. 170,P〈0. 05）,but positively correlated with MAPNF（ β = 0. 223,P〈0. 05）. Conclusion Salt-sensitivity might be correlated with vascular endothelial function in hypertensive patients.

关 键 词：盐敏感性风险分层 动态血压监测 血流介导血管舒张功能 原发性高血压 

分 类 号：R544.1[医药卫生—心血管疾病]