高血压患者血压昼夜节律消失与一氧化氮和内皮素关系的研究

目的探讨高血压昼夜节律与血浆一氧化氮(NO)和内皮素(ET)及其与左心室肥大的关系。方法选择原发性高血压患者90例,根据24 h动态血压(24ABPM)检测结果将其分为血压昼夜节律正常组50例及血压昼夜节律消失组40例;另选血压正常者30例作为对照组。采用G riess法测NO,用放射免疫法测ET;采用PH ILIPS HD I 5000型彩色多普勒仪测定三组受试者的室间隔厚度(IVS),左室舒张末期内径(LVDd)、左室后壁厚度(LVPW)、左心室重量(LVM),以>215 g为左心室肥大的诊断标准。结果血压昼夜节律消失组与血压昼夜节律正常组比较,ET、IVS、LVPW、LVDd、和LVM均显著增高,NO、ET、NO/ET明显降低(P<0.05)。夜间血压下降率与NO、NO/ET呈正相关(r=0.467,0.267,0.713,P<0.05),与ET、IVS、LVPW、LVDd和LVM呈负相关(r=-0.761~-0.264,P<0.05)。结论NO和ET水平可能参与昼夜血压节律的调节,ET升高与血压昼夜节律消失有关,并加重左心室肥大。

The correlation between the diurnal rhythm disorder and the blood levels of nitric oxide(NO) and endothelin(ET) in hypertension patients

Objective To investigate the relationship between the diurnal rhythm condition in hypertension(EH) and the blood levels of nitric oxide(NO) and endothelin(ET) and its correlation with the left ventricular hypertrophy(LVH).Methods 90 primary hypertension patients were divided into two groups that were normal blood pressure day-night rhythm group (50 cases)and vanished blood pressure day-night rhythm group(40 cases).Another 30 patients with normal blood pressures were regarded as control group.Griess methods were used to measure NO,radio-immunological methods were used to measure ET of hematoplasma,and PHILIPS HDI 5000 color Doppler was used to measure IVS,LVDd,LVPW and LVM.Results The ET,IVS,LVPW,LVDd and LVM levels were significantly increased and the NO,NO/ET levels were significantly decreased in the vanished blood pressure day-night rhythm group compared with the normal blood pressure day-night rhythm group.There was apositive correlation between night blood pressure drop rate and the NO,NO/ET,and a negative correlation between night blood pressure drop rate and the ET,IVS,LVPW,LVDd and LVM levels(P<0.05).Conclusion The increase of ET was related to the vanished blood pressure day-night rhythm,and it may aggravate left ventricular hypertrophy.