老年高血压患者内皮细胞功能的超声显像法研究

目的：应用超声显像法确定老年高血压患者的内皮细胞功能。方法：应用超声显像法对１３例老年高血压患者（６９±９岁）和１３例健康老年人（７２±６岁）肱动脉对反应性充血（诱发内皮细胞依赖性血管扩张）和舌下含服硝酸甘油（诱发内皮细胞非依赖性血管扩张）的反应进行了观察。结果：反应性充血诱发的肱动脉内径百分变化率老年高血压患者（６．７±３．３％）明显低于健康老年人（１３．３±１．８％，Ｐ＜０．０００１）。老年高血压患者的血流调节血管扩张与年龄（ｒ＝－０．３７，Ｐ＝０．０４）和平均血压（ｒ＝－０．５７，Ｐ＝０．０３）负相关。结论：老年高血压患者内皮细胞功能受损，且与年龄及平均血压有关，指出老化和高血压可独立损伤老年高血压患者肱动脉内皮细胞功能。

Ultrasonic Evaluation of Endothelial Function in Hypertensive El derly

Objective: To determine whether hypertension still exerts additional negative effect on endothelial function of large arteries in hypertensive elderly. Methods: We compared 13 elderly patients with hypertension(699 yeas)with 13 matched healthy elderly subjects(726 years).Using high resolution vascular ultrasound,we measured brachial artery responses to reactive hyperemia(with increased flow causing endotheliumdependent dilatation)and sublingual nitroglycerin(causing endotheliumindependent dilatation). Results: Flowmediated dilatation was significantly impaired in hypertensive elderly(6733% vs.13318% in control elderly,P<00001).Flowmediated dilatation in hypertensive elderly was inversely related to aging(r=-037,P=004)and mean blood pressure(r=-057,P=003). Conclusion: Our study showed decline in flowmediated dilatation in hypertensive elderly.This impairment of flowmediated dilatation in hypertensive elderly was related with age and mean blood pressure,indicating that aging and hypertension may independently impair endothelial function in the brachial artery of hypertensive elderly.