肝脏酶谱水平与血管内皮功能的关系

目的研究未治疗高血压门诊患者肝脏酶谱水平与血管内皮功能的关系。方法对400例怀疑有高血压但至少2周未进行降压治疗的患者，利用UNEXEF38仪器进行无创性血流介导性舒张功能（FMD）检测，并计算校正血管直径的FMD（FMDc）。采用日立全自动生化仪7600-020测定血清肝脏酶谱水平，包括γ谷氨酰转肽酶（GGT）、碱性磷酸酶（ALP）和谷丙转氨酶（ALT）。结果简单相关分析显示：血清GGT、ALP和ALT水平与FMD及FMDc均显著负相关（r值为-0．17--0．12，P〈0．05）。多元回归分析显示：血清GGT和ALP水平每增加2．7倍，FMD分别降低0．50％和1．05％（均P〈0．05），FMDc分别降低0．53％和1．07％（均P〈0．05）。在调整了混杂因素以后，血清ALT水平与两种FMD指标均无显著相关性（P〉0．05）。结论肝脏酶谱中，血清GGT和ALP水平升高是FMD降低的独立危险因素，而ALT水平与FMD无关。

Relationship between vascular endothelial function and levels of liver enzymes

Objective To investigate the relationship between the vascular endothelial function and the levels of liver enzymes of untreated outpatients with hypertension. Methods Four hundred outpatients who were suspected of having hypertension but not receiving antihypertensive treatments for at least two weeks were selected. The non-invasive flow-mediated dilatation （FMD） of patients was measured by the UNEXEF38. The FMD corrected for base arterial diameter （FMDc） was also calculated. The levels of serum liver enzymes were detected by the Hitachi automated Bioanalyzer 7600-020, including γ-glutamyl transpeptidase （GGT）, alkaline phosphatase （ALP）, and alanine transaminase （ALT）. Results The simple correlation analysis showed that levels of GGT, ALP, and ALT were all have significant negative correlation with FMD and FMDc （ r=-0.17 to -0.12, P〈0.05） . The multiple regression analysis showed that when the level of serum GGT and ALP increased by 2.7 times, FMD would decreased by 0. 500/0 and 1. 050/0 （P〈0.05） and FMDc would decreased by 0. 530/0 and 1. 070/0 （P〈0.05）. After confounding factors were adjusted, the level of serum ALT was not significandy correlated with the vascular endothelial function （P〉0.05）. Conclusion Among liver enzymes, increased serum GGT and ALP are independent risk factors for decreasing the vascular endothelial function, while the level of ALT is not correlated with the vascular endothelial function.