高血压患者内皮依赖血管舒张功能的研究

目的研究高血压（ＥＨ）患者内皮依赖血管舒张功能的变化及意义。方法应用Ｃｅｌｅｒｍａｊｅｒ方法观察肱动脉对增加流量（引致内皮依赖血管舒张）、含服硝酸甘油（引致非内皮依赖血管舒张）的反应性。结果对照组增加流量介导血管舒张（ＦＭＤ）与静息时血管内径（ＢＤ）呈负相关（ｒ＝－０．５７７，Ｐ＜０．０１）。ＥＨ患者ＦＭＤ较对照组显著减低（Ｐ＜０．０１），经协方差分析矫正ＢＤ的影响，ＥＨ患者ＦＭＤ仍低于对照组（Ｐ＜０．００１）。而硝酸甘油介导血管舒张（ＮＣＤ）两组间无明显差异（Ｐ＞０．０５）。　结论ＥＨ患者内皮依赖血管舒张功能减弱，可能与ＥＨ患者肱动脉内皮衍化舒张因子／一氧化氮（ＥＤＲＦ／ＮＯ）的贮备能力下降有关。

A Study of Endothelium Dependent Dilation of Brachial Arteries in Patients with Essential Hypertension

To study the alteration of endothelium-clependent dilation of patients with essential hypertension(EH).Method The responseness to uicreased flow(causing endothlium-dependent dilation)and sublingual nitroglycerin(causing endothelium-independent dilation)in brachial arteries were observecl by Celermajer's method.Results Flow-mediated dilation(FMD)was inversely related to baseline vessel diameter(BD)in control group(r=-0.577,P<0.01),FMD in EH group was reduced as compared with that in control group(P<0.0l).One way ANOCA showed that FMD was significantly reduced in EH group than in control group after correcting the effect of BD(P<0.001).Nitroglycerinum dilation in EH group is similar to that in control group(P>0.05).Conclusion Endothelium-dependent dilation in response to increased flow is impaired and endothelial dysfuction exists in patients with essential hypertension.This may be associated with L-arginine/NO path defect of brachial arteries