高频超声检测高血压及高血压合并高胆固醇血症患者血管内皮依赖性舒张功能

目的利用高分辨率超声技术对原发性高血压及高血压合并高胆固醇血症患者的内皮依赖性血管舒张功能进行研究和分析。方法采用高频超声技术,对74例患者其中25例原发性高血压患者(EH),25例高血压合并高胆固醇血症患者(EH+HC),和24例正常血压血胆固醇者(NT)的血管内皮依赖性舒张功能进行测定评价,并测定其血浆一氧化氮(NO),内皮素(ET),血栓素B2(TXB2)和前列腺环素(PGI2)等血管活性物质的浓度变化。结果发现EH+HC和EH组肱动脉血流介导的血管舒张百分率FMD(%)均较NT组明显减弱(P均<0.001),EH+HC组又较EH组明显减弱(P=0.021),而三组对硝酸甘油的反应无显著性差异(P均>0.05)。EH+HC及EH组血浆NO,PGI2水平均较NT组减低(P均<0.01),EH+HC组又较EH组明显降低(P=0.027)。结论高血压患者存在血管内皮依赖性舒张功能受损,高血压合并高胆固醇血症时,内皮功能损伤进一步加重,高频超声是评价血管内皮依赖性舒张功能的简单、无创、可靠的方法。

Endothelium-dependent Relaxation Assessed with High-resolution Ultrasound Image in Patients with Hypertension or Hypertension Complicated with Hypercholesterolemia

Objective To assess the endothelium-dependent relaxation in patients with hypertension or hypertension complicated with hypercholesterolemia with high-resolution ultrasound.Methods With high-resolution ultrasound,we measured endothelium-dependent relaxing function in 74 subjects 25 of whom with essential hypertension(EH),25 of whom with hypertension complicated with hypercholesterolemia(EH+HC)and the others as normal control.We measured the diameter of the superficial femoral and brachial arteries at rest,during reactive hyperaemia,re-test and after sublingual glyceryl trinitrate for evaluating the endothelium-independent dilatation in subjects.The level of plasma NO,ET,PGI 2,and TXB 2 were determined.Results There were significantly decreased flow-mediated dilatation in the EH or EH+HC patients than that in the normal persons.(All P<0.01) There was also significantly decreased flow-mediated dilatation in the EH+HC compared with those in the EH.(P=0.023),Contrarily dilatation to GTN did not differ from that in the control subjects.The concentration of plasma NO and PGI 2 in the EH and EH+HC were lower than those of the normal control.(All P<0.01).The concentration of plasma NO and PGI 2 were also significantly lower in the EH+HC than those in the EH(P=0.027).Conclusions Endothelium-dependent dilation was impaired in patients with hypertension.The degree of the impairment was more serious in patients with hypertension and hypercholesterolemia.High-resolution ultrasound image can be successfully used in assessing endothelium-dependent dilation.It is a simple,non-invasive and reliable technique.