正常高值血压者动脉血压昼夜节律与血管内皮功能及颈动脉内膜中层厚度的关系

目的了解正常高值血压动态血压昼夜节律及血管内皮功能(FMD)、颈动脉内膜中层厚度(IMT),探讨三者之间的关系。方法连续收集2010-08-12湘雅医院体检中心正常高值血压者104例,根据动态血压昼夜变化规律分为杓型组(55例)和非杓型组(49例),健康体检者40例为对照组。高分辨超声检测肱动脉FMD及颈动脉IMT。结果正常高值血压动态血压呈杓型及非杓型各占52.9%及47.1%,杓型组与非杓型组的IMT大于对照组(0.74±0.06)、(0.75±0.06)比(0.47±0.05)mm],FMD值小于对照组(8.07±1.18)%、(5.89±0.93)%比(13.78±1.98)%,均P<0.05],其中杓型组FMD大于非杓型组。FMD与IMT呈负相关(r=-0.843,P<0.01)。结论正常高值血压者存在血压节律异常、IMT增厚及FMD减退,动态血压呈非杓型者FMD损害较杓型者更严重。

Relationships between circadian rhythm of ambulatory blood pressure and vascular endothelial function and carotid intima-media thickness in prehypertensives

Objective To investigate the relationships between circadian rhythm of ambulatory blood pressure and carotid arterial intima-media thickness(IMT),vascular endothelial function assessed by flow mediated dilation(FMD) in prehypertensives.Methods One hundred and four prehypertensives collected continually from the physical examination center of Xiangya hospital between August 2010 and December 2010 were divided into two groups according to the circadian rhythm of ambulatory blood pressure monitoring(ABPM):the dipper group(55 cases) and the non-dipper group(49 cases).Forty normotensives were enrolled as control group.FMD and IMT were detected by high resolution ultrasonography.Results Dipper pattern and non-dipper pattern of prehypertension accounted for 52.9% and 47.1% respectively.Compared to the control group,IMT values of two prehypertensive groups were higher (0.74±0.06),(0.75±0.06) vs(0.47±0.05)mm,while the FMD values were lower(8.07±1.18)%,(5.89±0.93)% vs(13.78±1.98)%,all P<0.05].The FMD value of dipper group was higher than that of non-dipper group.FMD value was negatively correlated with IMT(r=-0.843,P<0.01).Conclusion Prehypertensives demonstrated abnormal ABPM rhythm,increased IMT value and decreased FMD.Compared to dipper prehypertensives,non-dipper individuals showed a more severe impairment of endothelial function as manifested by a reduced ability of FMD.