摘要
目的根据“内皮高血压心血管事件”链的病理发展进程,进一步了解高血压病与血管内皮功能的相互关系,以及降压药物对高血压患者血管内皮功能的影响。方法54例高血压患者按危险性分组,其中低中危组32例,高极高危组22例,对照组30例。采用超声测量3组肱动脉内皮依赖性舒张功能,并测定血浆内皮素、血管性血友病因子。然后采用氨氯地平或氨氯地平+卡维地洛治疗,12周以后复查上述指标。结果静息状态下,3组间肱动脉内径、流量无明显差异;压迫后高极高危组内径扩张程度低于对照组(6.6%vs 12.1%;P<0.01),低中危组与对照组无显著性差异(10.2%vs 12.1%;P>0.05);血浆内皮素、血管性血友病因子在高极高危组较对照组有显著升高(P<0.05),低中危组与对照组相似(P>0.05);经氨氯地平和卡维地洛治疗12周,血压下降,肱动脉超声内皮功能和血液内皮标志物均有改善。结论高血压患者内皮功能受损与血压增高和伴随的靶器官损伤有关。降压治疗可改善高血压患者血管内皮功能。
Objective To explore the impairement of endothelium dependent vasodilatation in the different risk level in essential hypertension. Methods Based on the numbers of risk factors, patients were stratified into low risk（n=32） and high risk group（n=22）. Flow-mediated vasodilatation （FMD） were determined in right brachial artery by ultrasound. Serum endothelin （ET-1） and yon Willibrand Factor （VWF） were measured. Patients were randomly assigned to receive Amlodipine 5 mg/d or combined with Carvedilol 12. 5 mg/d. The endothelium functions tests were reexamined 12 weeks after treatment. Results In higher risk group FMD is markedly lower than that in the control （6.6%±4.1% vs control 12. 1% ±4. 4%, P〈0.01 ）. However, FMD in low risk group is slightly lower than that in control （10. 2 %± 4. 5% vs 12.1%±4.4%, P〉0. 05）. No difference in ET-1 and VWF between low risk group and control （P〉0. 05） was found, while they were elevated in high risk group （P〈0. 05）. After 12 weeks treatment with amlodipive （n=25） and combined amlodipine with carvedilol （n= 20）. Both blood pressure and endothelium function have been significantly improved. Conclusion The endothelial dysfunction is closely associated with the risk level of essential hypertension with nonsignificant endothelial dysfunction in low risk patients but substantial in high risk group.
出处
《高血压杂志》
CSCD
北大核心
2006年第4期257-260,共4页
Chinese Journal of Hypertension
关键词
高血压病
内皮功能
超声
内皮素
血管性血友病因子
Essential hypertension
Endothelial dysfunction
Ultrasound
Endothelin-1
Von williband factor
