摘要
目的探讨高血压病患者压力感受器敏感性(BRS)情况及其可能影响因素。方法用全自动生化仪测定血脂、血糖,用倾斜方法同时记录血压和心率,BRS=(最低血压时RR间期-基础RR间期)/(最低血压-基础血压),用袖带对肱动脉加压后放气,测定肱动脉内径变化率的方法代表血流介导的内皮舒张功能。结果(1)高血压病患者的BRS明显小于正常对照组[(6.9±7.3vs13.9±3.6)ms/mmHg,P<0.01],亦明显小于肾性高血压组[(6.9±7.3vs12.2±6.2)ms/mmHg,P<0.01];高血压病BRS有随着高血压分级增高而下降趋势,1级患者BRS大于3级患者[(10.2±4.0vs5.4±4.8)ms/mmHg,P<0.01],2级患者BRS大于3级患者[(7.6±2.4vs5.4±4.8)ms/mmHg,P<0.01];(2)高血压病伴高脂血症患者BRS小于高血压病不伴高脂血症组[(2.2±4.7vs7.2±6.4)ms/mmHg,P<0.01];(3)高血压病患者血管内皮舒张功能与BRS相关(r=0.565,P<0.01),肾性高血压组内皮舒张功能与BRS相关(r=0.573,P<0.05),正常对照组内皮舒张功能与BRS相关(r=0.610,P<0.05)。结论(1)BRS功能降低可能是高血压病发病原因之一;(2)降脂治疗可通过升高BRS,改善高血压病患者的预后;(3)血管内皮舒张功能与BRS有关,可通过改善血管内皮舒张功能改善BRS。
Objective To investigate the baroreflex sensitivity （BRS） of the essential hypertensive （EH） and its possible related factors. Methods The blood sugar and lipid profile were measured, BRS were calculated by oblique position method, when blood pressure and heart rate were recorded simultaneously. Blood flow-mediated endothelium relaxation function（FMD） was examined in the brachial artery by uhrasonography. Results （1） BRS in patients with hypertension was lower than that in normal control （NC）（6.9±7.3 vs 13.9±3.6 ms/mm Hg, P〈0.01）, and was also lower than that in the renal hypertensive（RH） （6.9±7.3 vs 12.2 ± 6.2 ms/mm Hg, P〈0.01）. However, BRS has a trend of declination with the grades of hypertension. BRS was higher in patients of first stage EH than that of the third stage EH（10.2±4.0 vs 5.4±4.8 ms/mm Hg, P〈0.01）, second grade higher than that of the third grade EH （7.6±2.4 vs 5.4±4.8 ms/mm Hg, P〈0.01） ; （2） BRS in EH complicated with hypercholesterolemia is lower than EH without hypercholesterolernia （2.2±4.7 vs 7.2±6.4 ms/mm Hg, P〈0.01） ; （3）FMD correlated with the BRS in EH（r=0. 565, P〈0.01）, as well as in RH （r=0. 573,P〈0.05） and in NC（r =0. 610, P〈0.05 ）. Conclusion The reduced baroreflex sensitivity may be one of the mechanism of the developement of the essential hypertension. Anti-hyperlipidemia therapy is beneficial to hypertensive patients via promotion of BRS. Blood-mediated endothelium relaxation function apparently related with the BRS.
出处
《高血压杂志》
CSCD
北大核心
2006年第6期436-438,共3页
Chinese Journal of Hypertension
