青年高血压血管内皮功能损伤及早期动脉硬化改变

目的 探讨青年高血压血管内皮功能损伤及其早期动脉粥样硬化改变.方法 2005年3 -4月在陕西汉中七里、老君、沙沿3个乡20个村中,按数字表法随机抽取6个村的20 ～ 35岁农村青年进行血压等相关因素调查.检出高血压患者97例(高血压组),血压正常者400名(正常组).采用高分辨率血管超声法检测患者肱动脉血流介导的内皮依赖性血管舒张功能(FMD),颈动脉内膜中膜厚度(IMT)以及其他生化指标.结果 青年高血压组BMI[(24.7 ±4.3)kg/m2]、腰围[(84.1±11.7) cm]、臀围[(92.5±7.4)cm]、TC[(4.6±0.8) mmol/L]、LDL-C[(2.8±0.5) mmol/L]、TG[( 1.7±1.1) mmol/L]及血胰岛素(INS)[(8.6±4.4)mIu/L]均高于血压正常组[分别为(22.1 ±3.0) kg/m2、(76.7±8.9) cm、(88.9±5.6) cm、(4.3±0.7) mmol/L、(2.6±0.4) mmol/L、( 1.4±0.8)mmol/L、(6.9 ±2.1)mlu/L],差异均有统计学意义(P值均＜0.05).高血压组血流介导的FMD低于血压正常组,分别为(0.103 ±0.04)％和(0.117±0.05)％(P＜0.05)；两组IMT分别为(0.49 ±0.07)mm和(0.48±0.07) mm,差异无统计学意义(P＞0.05).结论 青年高血压较早存在内皮依赖性血管FMD损害,并先于颈动脉内膜-IMT的改变.

The vascular endothelial function damage as well as early atherosclerosis in hvpertensive vouth

Objective To explore young hypertensive people's vascular endothelial dysfunction and the early atherosclerosis changes.Methods Rural youth subjects aged 20 to 35 in 6 villages were randomly selected from 20 villages of 3 townships,including Qili,Laojun and Shayan,in Hanzhong,Shanxi,China,from March to April of 2005,to survey their blood pressure and other related factors.97 subjects with high blood pressure (hypertensive group) were detected while 400 with normal blood pressure ( normal group).We measured their brachial artery flow-mediated vascular endothelial-dependent diastolic function (FMD) and the carotid intima-media thickness (IMT) by high resolution vascular ultrasound method,and other biochemical indexes.Results The body mass index (BMI) ((24.7 ±4.3)kg/m2),waistline ((84.1 ±11.7 ) cm),hipline ( ( 92.5 ± 7.4 ) cm ),TC ( ( 4.6 ± 0.8 ) mmol/L),LDL-C ( ( 2.8 ± 0.5 ) mmol/L),TG ( ( 1.7 ± 1.1 )mmol/L) and the blood insulin (INS) ( (8.6 ±4.4) mIu/L) were all significantly increased in young hypertensive group than those in normotensive group (respectively were (22.1 ± 3.0 ) kg/m2,(76.7 ± 8.9 ) cm,( 88.9 ± 5.6 ) cm,(4.3 ± 0.7 ) mmol/L,( 2.6 ± 0.4 ) mmoL/L,( 1.4 ± 0.8 ) mmol/L and (6.9±2.1 )mIu/L)(P ＜0.05).The FMD of the brachial artery in hypertensive group was markedly lower than normal group ( ( 0.103 ± 0.04 ) ％ and ( 0.117 ± 0.05 ) ％,P ＜ 0.05 ).The IMT of two groups were ( 0.49 ± 0.07 )mm and ( 0.48 ± 0.07 ) rmm,but there was no statistically significant differences ( P ＞ 0.05 ).Conclusion Young hypertensive people with a few cardiovascular risk factors earlier appear dysfunction of the flow-mediated vascular endothelial-dependent dilation,which is prior to the increase in carotid IMT.