轻中度高血压病人血管功能及结构的超声评价及其与血管活性因子的相关性  

The Ultrasound Estimation to Vascular Change in Mild and Moderate Hypertension Patients and the Relation with Vasoactive Factors

作　　者：李湘燕[1] 张春丽[2] 赵玮[1] 祁芸云[1] 欧阳福珍[1] 

机构地区：[1]北京大学第一医院老年内科,北京100034 [2]北京大学第一医院核医学科,北京100034

出　　处：《中国医药导刊》2003年第3期189-191,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:通过超声观察轻中度高血压病人的内皮功能和血管壁的结构变化,同时探讨其与血压水平和血管活性因子的相关性。方法:22名未经治疗的原发性高血压病人,按血压水平分为轻度高血压和中度高血压组,分别运用血管超声观察内皮介导的血管扩张(FMD),硝酸甘油介导的血管扩张(NMD),内膜中层厚度(IMT),壁-腔比值(M/D)。放免法测定血浆内皮素(ET-1)和血管紧张素Ⅱ(AngⅡ)水平,两组间比较,并将上述指标,血压水平,年龄,体重指数(BMI)与M/D行多元回归分析。结果:轻中度高血压组间FMD,NMD,IMT,M/D和AngⅡ无明显差异,ET-1水平在中度高血压组较轻度高血压组显著升高(P<0.05)。多元回归结果显示,BMI和ET-1对M/D有影响(β=-0.48,P=0.01;β=-0.365,P=0.04)。结论:血管超声观察高血压病人的肱动脉内皮功能及血管壁结构变化是一种方便,实用的方法,可用于高血压血管内皮功能和结构变化的评价及追踪观察。高血压病人的血管内皮功能的下降及结构改变并不随血压水平的升高而加重。血浆内皮素水平与超声观察血管壁结构变化相关。Objective: To observe the change of the endothelial function and vascular wall structure in mild and moderate hypertensive patients, and investigate its relationship with the level of blood pressure and vasoactive factors. Methods: 22 essential hypertensive patients with no treatment were selected to undergo ultrasound. They were divided into mild and moderate hypertension groups according to the level of blood pressure. FMD, NMD, IMT and M/D in the brachial artery were measured. And plasma level of ET - 1 and Ang Ⅱ were determined by radioimmunoassay method. Compare all of these data between two groups and perform multiple regression of criteria above and age, BMI, blood pressure to M/D.Results: There are no significant difference of FMD, NMD, IMT, M/D and AngⅡ between two groups. But the plasma level of ET - 1 in moderate group is significantly higher than that in mild group (P < 0.05). And multiple regression showed BMⅠ and the plasma level of ET - 1 had relationship with M/D (β = - 0.48, P = 0.01; β= - 0.365, P = 0.04). Conclusion: The ultrasound can be used in observation of change in endothelial function and vascular wall structure in hypertensive patients. The decrease of endothelial function and the change of vascular wall in hypertensive patients are not aggravated in the group with higher blood pressure. The plasma level of ET - 1 is correlated with change of the vascular wall structure observed by ultrasound.

关 键 词：轻中度高血压 血管功能 血管结构 超声 内皮功能 硝酸甘油 血管扩张 血浆内皮素 血管紧张素Ⅱ 

分 类 号：R544.1[医药卫生—心血管疾病]