血管紧张素Ⅱ对内皮依赖性血管舒张功能的影响  

The effect of angiotensinⅡ on endothelium-dependent vasodilatation

作　　者：张桂清[1] 曾秋棠[1] 曹林生[1] 袁杰[1] 董晓雁[1] 王夜明[1] 王祥贵[1] 赵宏[1] 

机构地区：[1]华中科技大学同济医学院心血管病研究所华中科技大学同济医学院附属协和医院心内科

出　　处：《临床心血管病杂志》2003年第11期663-665,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨血浆中血管紧张素Ⅱ (AngⅡ )水平与肱动脉内皮依赖性舒张功能的关系。 方法 :测定冠心病 (CHD)组 30例、原发性高血压 (EH)组 2 8例、EH并发CHD(EH加CHD)组 39例和正常对照组 2 0例的血脂、AngⅡ、vWF、内皮素 1(ET 1)、一氧化氮 (NO)水平以及反应性充血时和含服硝酸甘油后肱动脉内径的变化。结果 :EH组、CHD组和EH加CHD组血流介导的肱动脉舒张 (FMD)和硝酸甘油所致的肱动脉舒张均低于对照组 [分别为 (7.32± 4 .36 )、(5 .6 2± 3.0 9)和 (3.72± 3.0 6 ) %∶(14 .2 1± 7.71) %以及 (17.82± 6 .0 0 )、(12 .6 1±4 .2 9)和 (9.5 2± 4 .85 ) %∶(19.33± 9.6 2 ) % ,均P <0 .0 5 ]。多因素线性逐步回归分析显示 :在CHD组和EH加CHD组与血清高密度脂蛋白胆固醇 (HDL C)水平呈正相关 [分别为 (r =0 .317,P <0 .0 1)和 (r =0 .2 98,P <0 .0 1) ],EH加CHD组与血浆AngⅡ水平呈负相关 (r =- 0 .4 71,P <0 .0 1) ;剔除HDL C影响因素后仍呈负相关 (r =- 0 .2 84 ,P >0 .0 1) ,硝酸甘油所致的肱动脉舒张与上述各因素无关。根据FMD程度将 4组受试者合并后再分为A、B两组 ,A组FMD≤ 5 % ,B组FMD >5 % ,结果显示 ,A组的AngⅡ和ET 1明显高于B组 [分别为(10 1.4 5± 13.4 2 )∶(35 .6 4± 9.6 2 )Objective:To evaluate the correlation between plasma angiotensinⅡ(AngⅡ) levels and endothelium-dependent dilatation of brachial arteries.Methods:Plasma of AngⅡ, vWF, endothelin-1(ET-1), NO, serum lipids and the dilatation changes of arteries during reactive hyperemia and sublingual nitroglycerin(NTG) were measured in 117 subjects whose total cholesterol levels were relatively normal. There were 30 patients with established coronary heart disease(CHD), 28 patients with essential hypertention(EH), 39 patients with CHD+EH and 20 controls.Results:Both flow-mediated dilatation(FMD) and NTG-induced dilatation of brachial arteries in patients of EH, CHD and CHD+EH groups were obviously reduced compared with control group[( 7.32± 4.36)%,( 5.62± 3.09) and ( 3.72± 3.06)% vs ( 14.21± 7.71)%; ( 17.82± 6.00)%, ( 12.61± 4.29)% and ( 9.52± 4.85)% ∶ ( 19.33± 9.62)%,respectively, P< 0.05 for all]. Multiple linear stepwise regression analysis showed that FMD of brachial arteries in CHD and CHD+EH groups were positively related to HDL-C[(r= 0.317, P> 0.01) and (r= 0.298,P< 0.01), respectively]. But in CHD+EH group, it was negatively related to AngⅡ(r=- 0.471, P< 0.01). And so did when was the agent of HDL-C eliminated (r=- 0.284, P> 0.01). No significant correlation was observed, however, between NTG-induced dilatation of brachial arteries and the above factors. All subjects were divided into two groups (group A and group B) according to the degree of FMD of brachial arteries. The FMD of brachial arteries was ≤5% in group A and >5% in group B. The plasma levels of AngⅡand ET-1 in group A were significantely higher than those in group B[( 101.45± 13.42)∶( 35.64± 9.62) ng/L and ( 97.14± 23.11)∶( 44.53± 13.52) ng/L, respectively, P< 0.01 for all].Conclusion:Both endothelium-dependent and endothelium-independent vasodilatation are impaired in patients with coronary heart disease and essential hypertention followed CHD. Angiotensin Ⅱ has effects on endothelial injury and

关 键 词：高血压 血管紧张素Ⅱ 内皮 血管 动脉粥样硬化 

分 类 号：R544.1[医药卫生—心血管疾病]