高血压患者脉压和脉压指数与血管内皮功能的关系

目的研究原发性高血压(EH)患者的脉压(PP)和脉压指数(PPI)与血管内皮功能的相互关系,探讨EH患者PP增大和PPI增高导致靶器官损害的机制。方法对108例EH患者进行24h动态血压监测。按动态脉压(APP)<40mmHg、40~60mmHg和>60mmHg三组;按PPI<0.35、0.35~0.45和>0.45三组进行分析。结果(1)各亚组年龄、内皮素-1(ET-1)、一氧化氮(NO)、ET-1/NO和假性血管性血友病因子(VWF)差异有显著性,随着24hAPP和PPI的增加,年龄、ET-1、ET-1/NO和VWF也增加(P<0.01或P<0.05),而NO减少(P<0.05)。(2)多元逐步回归分析显示在排除众多因素后,24h APP或PPI与ET-1和VWF呈正相关(P均<0.01),与NO呈负相关(P<0.01)。(3)在与血管内皮功能的相关性方面,PPI与PP具有很好的一致性,但PPI相关性更好(r值更接近于1)。结论PP升高和PPI增大导致血管内皮功能受损。

Relation ship etween pulse pressure, pulse pressure index and endothelial function in patients with essential hypertension

Objective To observe the relationship between pulse pressure(PP) and pulse pressure index(PPI) and endothelial function in patients with essential hypertension and explore the mechanism of increased PP and PPI inducing target organs damage.Methods Twenty-four hours' ambulatory blood pressures(24hAPP) were monitored,the patients were divided into three groups according to the level of ambulatory PP(APP): GroupⅠ:PP<40mmHg;GroupⅡ:PP40～60mmHg;GroupⅢ:PP>60mmHg.and were divided into three groups according to the level of PPI:Group A:PPI<(0.35;) Group B:PPI 0.35～0.45;Group C:PPI>0.45.Results (1) The Age,endothelin-1(ET-1),nitric oxide(NO),ET-1/NO,Von Willebrand factor(VWF) were significantly different among the subgroups of PP and PPI(all P<0.01 or P<0.05).(2) The Age,ET-1,ET-1/NO and VWF were positively correlated to the PP and PPI;NO was negatively correlated to the PP and PPI(all P<0.01).(3)Stepwise multiviate regression analysis disclosed that ET-1 and VWF all alone and jointly positively correlated with PP and PPI(all P<0.01),and that NO negatively correlated with PP and PPI(all P<0.01).Conclusion The increased PP and PPI induces damaged endothelial function.PP and PPI were of analogous extent of importance in the correlation between them and endothelial function.