高频超声检测高血压及高血压合并糖尿病患者血管内皮依赖性舒张功能

目的利用高分辨力超声技术对原发性高血压及高血压合并糖尿病患者的内皮依赖性血管舒张功能进行研究和分析.方法采用高频超声技术,对72例患者[其中25例原发性高血压患者(EH),25例高血压合并糖尿病患者(EH DM)和22例正常血压血糖患者(NT)]的血管内皮依赖性舒张功能进行测定评价,并测定其血浆一氧化氮(NO)内皮素(ET)血栓素B2(TXB2)和前列腺环素(PGI2)等血管活性物质的浓度变化.结果发现EH DM和EH组肱动脉血流介导的血管舒张百分率FMD(%)均较NT组明显减弱(P均<0.001),EH DM组又较EH组明显减弱(P=0.021),而3组比较对硝酸甘油的反应无显著性差异(P均>0.05).EH DM及EH组血浆NO,PGI2水平均较NT组减低(P均<0.01),EH DM组又较EH组明显降低(P=0.027).结论高血压患者存在血管内皮依赖性舒张功能受损,高血压合并糖尿病时,内皮功能损伤进一步加重,高频超声是评价血管内皮依赖性舒张功能的简单、无创、可靠的方法.

Endothelium-dependent Relaxation Assessed with High-resolution Ultrasound Image in Patients with Hypertension or Hypertension Complicated with Diabetes Mellitus

Objective To assess the endothelium dependent relaxation in patients with hypertension or hypertension complicated with diabetes mellitus with ultrasound.Methods With high resolution ultrasound,we measured endotheliu dependent relaxation function in 72 subjects including 25 with essential hypertension(EH),25 with hypertension and diabetes(EH DM)and the others as the normal control We measured the diameter of the superficial femoral and brachial arteries at rest,during reactive hyperaemia,re test and after sublingual glyceryl trinitrate causing endothelium independent dilatation The level of plasma NO,ET,PGI 2,and TXB 2 were determined Results There were significantly smaller flow mediated dilatation in the EH or EH DM patients than in the normal persons (All P <0 01) There was also significantly smaller flow mediated dilatation in the EH DM compared with those in the EH P =0 021),but dilatation to GTN did not differ in all the three groups The concentration of plasma NO and PGI 2 in the EH and EH Dm were lower than in the normal control ( P <0 01) The concentration of plasma NO and PGI 2 in the EH DM was also significantly lower than those in the EH ( P =0 029) Conclusions Endothelium dependent dilation was impaired in patients with hypertension The degree of function impaired was more serious in patients with hypertension and diabetes mellitus High-resolution ultrasound image which is a simple,non-invasive and reliable technique can be successfully used in assessing endothelium-dependent dilation