原发性高血压患者红细胞分布宽度、中性粒细胞/淋巴细胞比值与内皮功能关系的研究

目的 探讨原发性高血压患者血压、血管内皮功能与红细胞分布宽度（red blood cell distribution width，RDW）、中性粒细胞/淋巴细胞比值（neutrophil/lymphocyte ratio，NLR）的关系。方法 入选111例未经治疗的轻度原发性高血压患者，所有受试者均采用Endo-PAT2000无创内皮功能检测仪检测反应性充血指数（reactive hyperemia index，RHI），并根据RHI的数值将高血压患者分为两组：RHI正常组（RHI>1.67）63例和RHI异常组（RHI ≤ 1.67）48例。并检测外周血常规、血生化，测量收缩压及舒张压，计算NLR及脉压（pulse pressure，PP）。结果 RHI异常组收缩压、脉压、中性粒细胞计数、RDW及NLR值明显高于RHI正常组，差异有统计学意义（P<0.05）。Pearson相关分析结果表明RDW与收缩压（r=0.254，P=0.007）、脉压（r=0.366，P<0.01）呈正相关；NLR与收缩压（r=0.325，P<0.01）及脉压（r=0.235，P=0.013）呈正相关；RHI与收缩压（r=-0.300，P=0.001）及脉压（r=-0.311，P=0.001）呈负相关；NLR与RHI呈负相关（r=-0.358，P<0.01），差异均具有统计学意义（P<0.05）。结论 原发性高血压与NLR及RDW呈正相关，收缩压越高，RDW及NLR越高，RDW、NLR可能是高血压的独立危险因素。

Relationship between RDW,neutrophil/lymphocyte ratio and endothelial function in essential hypertensive patients

Objective To investigate the relationship between red blood cell distribution width(RDW), neutrophil/lymphocyte ratio (NLR) and endothelial function in essential hypertensive patients. Methods We continuous enrolled 111 hypertensives patients from the Xuanwu hospital affiliated to Capital Medical University under the strict inclusion criteria. The Endo-PAT2000(Itamar Medical Inc.Caesarea) noninvasive testing equipment of vascular endothelial function measured reactive hyperemia index (RHI) which was used to evaluate vascular endothelial function and arterial stiffness in morning fasting adoption.Patients were divided into two groups:normal RHI group(RHI>1.67,n=63),abnormal RHI group (RHI ≤ 1.67,n=48).We also recorded age, blood pressure, history of smoking, fasting blood check. Results Systolic blood pressure (SBP) and pulse pressure (PP) in abnormal RHI group were significantly higher than those in normal RHI group.The Pearson correlation analysis indicated that, RHI was negatively associated with NLR(r=-0.358, P<0.01),SBP(r=-0.300, P=0.001)and PP(r=-0.311, P=0.001).Conclusion RHI gradually was declined with the elevation of NLR levels in hypertensives, and there was a linear correlation between them, which indicated that they may be associated with hyertensives endothelial injury. Further longitudinal studies are needed to better understand the causal relationship between endothelial function and NLR.