摘要
目的:探讨肾性高血压患者血管内皮功能与左心室舒张功能之间的关系。方法:采用高频率超声观察50例肾性高血压患者和20例健康对照者肱动脉充血后反应性扩张(DTRH)和含服硝酸甘油后血管内径的变化(DTNG)。应用多普勒组织显像技术检测二尖瓣环的舒张早期峰值速度(Ea)、舒张晚期峰值速度(Aa)及两者之间的比值(Ea/Aa)。结果:Ea/Aa正常及异常的肾性高血压患者DTRH均低于对照组(P<0.05),且Ea/Aa异常的患者DTRH低于Ea/Aa正常的高血压病患者[(4.12±1.98)%vs(7.89±2.14)%,P<0.05],而DTNG在Ea/Aa正常及异常的肾性高血压患者和对照者之间无显著性差异(P>0.05)。肾性高血压患者DTRH与二尖瓣环Ea/Aa比值及Ea呈正相关(r=0.68,P<0.01和r=0.48,P<0.05),与Aa呈负相关(r=-0.32,P<0.05)。结论:肾性高血压患者血管内皮功能改变与左室舒张功能的变化密切相关,内皮功能障碍可能在肾性高血压患者左室舒张功能发展中起作用。
Objective：To explore the relationship between brachial artery endothelial function and left ventricular diastolic function in patients with hypertension from renal disease by ultrasonography.Methods：Measurements of brachial artery diameter were performed by high-resolution ultrasonography during baseline,reactive hyperemia（DTRH）and sublingual nitroglycerin administration（DTNG）in 50 patients and 25 healthy subjects.The percent changes in brachial artery diameter induced by DTRH and DTNG were calculated.Mitral annulus velocity were detected by Doppler tissue imaging.Maximal velocities in early diastole（Ea）,and in atrial contraction（Aa） were measured and the ratio of Ea/ Aa（Ea/Aa）was calculated.Results：The percent change in the brachial artery diameter induced by DTRH in patients was significantly less than that in healthy subjects（P0.05）,while it was significantly less in patients with abnormal Ea/Aa than that in patients with normal Ea/Aa[（4.12±1.98）%vs（7.89±2.14）%,P0.05].No significant difference could be found in DTNG between patients and controls（P0.05）.Positive correlation was found between DTRH and Ea/Aa,Ea（r=0.68,P0.01,r=0.48,P0.05,respectively）.Negative correlation was found between DTRH and Aa（r=-0.32,P0.05）.Conclusion：Endothelial dysfunction was related with left ventricular diastolic dysfunction in patients with hypertension from renal disease.It might play an important role in development and progression of left ventricular diastolic dysfunction.
出处
《医学理论与实践》
2010年第7期775-777,共3页
The Journal of Medical Theory and Practice
关键词
肾性高血压
血管内皮功能
左室舒张功能
Hypertension from renal disease
Endothelial function
Left ventricular diastolic function
