糖耐量减低合并原发性高血压患者血管内皮功能的变化

目的观察糖耐量减低（IGT）合并原发性高血压（EH）对血管内皮功能的影响。方法选择38例IGT合并EH患者，分别测定血浆内皮素（ET）、一氧化氮（NO）水平，并应用高分辨率超声测量不同情况下右侧肱动脉舒张末期内径，包括静息时肱动脉的基础内径（D0）、流量介导血管舒张时肱动脉内径（D1）和含服硝酸甘油介导血管舒张时肱动脉内径（D2），并分别计算流量介导血管舒张时肱动脉内径较基础内径的变化率（即内皮依赖性舒张功能，△D1）和含服硝酸甘油介导血管舒张时肱动脉内径较基础内径的变化率（即非内皮依赖性舒张功能，△D2）。选择32例单纯原发性高血压患者作为EH对照组和38例查体健康者作为健康对照组。结果三组ET值比较，IGT合并EH组〉EH对照组〉健康对照组，两两比较差异有统计学意义（P〈0．05）。三组NO值比较，IGT合并EH组〈EH对照组〈健康对照组，两两比较差异有统计学意义（P〈0．05）。三组内皮依赖性舒张功能（△D1）比较，IGT合并EH组〈EH对照组〈健康对照组，两两比较差异有统计学意义（P〈0．05）。三组非内皮依赖性舒张功能（△D2）无明显差异。结论IGT和EH均为血管内皮损伤的独立危险因子，而且两者有明显的协同破坏作用，IGT合并EH时血管内皮功能损伤更加明显，此时更应该提早干预，以更好地预防心脑血管疾病的发生和发作。

Effect of decrease of impaired glucose tolerance with essential hypertension on blood vessel endothellum function

Objective To observe the effect of the blood vessel endothelium function under decrease of impaired glucose tolerance （IGT） with essential hypertension （EH）. Methods 38 cases of IGT with high blood pressure （HBP） were selected. The levels of ET and nitro oxide （NO） in blood plasma were detected. The inner diameters of right arteria brachialis in end-diastole and resting （ Do ） were measured. The inner diameters of right arteria in vasodilatation with flow mediated （ Dt ） and glycerol trinitrate mediated （ D2 ） were measured by high resolution uhrasonometry respectively. The different variation rates between flow mediated （ △ D1） and glycerol trinitrate mediated （△ D2） were calculated. 32 cases of HBP and 38 healthy volunteers were selected as the control group. Results The difference of ET between IGT with EH and control was statistically significant （P〈0.05） as well as the levels of NO. The level of ET was the highest in IGT with EH group as the level was the lowest in control group. The level of NO was the highest in control group as the level was the lowest in IGT with EH. The difference of glycerol trinitrate mediatedvariation （△ D2） was not found in our study. Conclusion The IGT and EH are independent risk factors, and they can work synergistically. The damages of blood vessel endothelium are severe with IGT and EH. The early intervention can decrease the incident rate of heart and cerebrovascular diseases.