原发性高血压颈动脉粥样硬化、肱动脉内皮功能与内皮素1、C-反应蛋白关系的研究  

Relationship of Atherosclerosis and Endothelial Function With Endothelin-1 and C-reactive Protein in Patients With Essential Hypertension

作　　者：张俊[1] 罗开良[1] 刘增长[1] 殷耀辉[1] 佘强[1] 淡学川[1] 邓昌明[1] 胡容[1] 吕湛[2] 

机构地区：[1]重庆医科大学附属第二医院心内科,重庆市400010 [2]重庆医科大学附属第一医院心内科

出　　处：《中国循环杂志》2003年第4期288-291,共4页Chinese Circulation Journal

摘　　要：目的 :研究原发性高血压患者大动脉粥样斑块、内皮功能与内皮素 1和C 反应蛋白的关系。　　方法 :选择 10 9例原发性高血压患者 ,其中男性 5 6例 ,女性 5 3例 ,平均年龄 (60 8± 6 2 )岁。应用B型超声对所有病例颈动脉、肱动脉进行扫查 ,检测颈动脉内膜中层厚度 (IMT)及粥样斑块 ,在静息、反应性充血时分别测量肱动脉内径 ,用免疫学方法测定血液中内皮素 1、C 反应蛋白浓度。然后分析超声结果与内皮素 1、C 反应蛋白浓度的关系。　　结果 :随着IMT增厚 ,内皮素 1、C 反应蛋白浓度亦增大 ,各组之间差异均有显著性 (P <0 0 1) ,粥样斑块 1、 2、3级内皮素 1、C 反应蛋白浓度高于粥样斑块 0级 (P <0 0 5 )。加压充血后 ,肱动脉管径的内皮依赖性血管扩张(Flow MD)与内皮素 1、C 反应蛋白浓度呈负相关 ,相关系数分别是 -0 62 7、 -0 693 (P <0 0 0 1)。　　结论 :原发性高血压患者血液中内皮素 1、C 反应蛋白浓度增高与肱动脉内皮细胞功能受损、颈动脉粥样硬化关系密切。Objective: To explore the relationship of atherosclerosis and endothelial function with endothelin-1 and C-reactive protein in patients with essential hypertension. Methods: One hundred and nine patients with hypertension were selected, including 56 males and 53 females, [mean age (60.8±6.2) years]. B-mode ultrasound was used to scan carotid, brachial arteries of all patients in order to check and measure intima-media thickness(IMT), plaques of carotid arteries and diameter of brachial arteries at rest and during reactive hyperemia. Endothelin-1( ET-1 ), C-reactive protein(CRP) were determined with immunology method. The relation between results measured with ultrasound instrument and concentrations of ET-1, CRP was analyzed. Results: Positive correlation was found between concentrations of ET-1, CRP and IMT. Concentrations of ET-1, CRP were higher in plaque groups than those in non-plaque groups ( p <0.05). Negative correlation was found between flow-mediated dilatation ( Flow-MD,% ) and ET-1, CRP. The correlation coefficient was -0.627 and -0.693, respectively ( p <0.001). Conclusion: The increased concentrations of ET-1 and serum CRP were closely correlated with decreased endothelial function of brachial arteries and atherosclerosis of carotid arteries in patients with essential hypertension.

关 键 词：原发性高血压 颈动脉粥样硬化 肱动脉 内皮功能 内皮素l C-反应蛋白 

分 类 号：R544.1[医药卫生—心血管疾病] R543.4[医药卫生—内科学]