原发性高血压患者血清Fractalkine 水平与血管内皮功能损伤的相关性研究

目的 研究原发性高血压患者Fractalkine（FKN）与血管内皮功能的相关性。方法 纳入50 例原发性高血压患者作为高血压组，50 例健康体检者为对照组。使用酶联免疫吸附法（ELISA）测定血清FKN水平，使用高效液相色谱法测定血浆非对称性二甲基精氨酸（ADMA）水平，硝酸还原酶法测定血清一氧化氮NO 水平。使用高分辨超声检测肱动脉血流介导的内皮依赖性血管舒张功能（FMD）及非内皮依赖性舒张功能（NMD）。38 例原发性高血压患者（剔除12 例）接受3 个月的规范降压治疗。比较治疗前后收缩压、FKN、ADMA、NO、FMD 的变化水平，进一步分析FKN 治疗前后变化量绝对值与收缩压、ADMA、NO、FMD 变化量绝对值的相关性。结果 与对照组比较，高血压组的血清FKN、血浆ADMA 水平升高（P <0.05），FMD、血清NO 水平降低（P <0.05）。FKN 与ADMA、收缩压、舒张压呈正相关（r =0.785、0.730 和0.785，均P =0.000），与NO、FMD 呈负相关（r =-0.800 和-0.783，均P =0.000）。经过3 个月的降压治疗，发现收缩压、舒张压、FKN、ADMA 比治疗前降低，NO、FMD 比治疗前升高。其中FKN 治疗变化绝对值（△ FKN）与△收缩压、△舒张压、△ FMD、△ ADMA、△ NO 呈正相关（r =0.720、0.405、0.707、0.687和0.726，P =0.000、0.012、0.001、0.032 和0.001）。结论 原发性高血压患者血清FKN 水平的升高与血管内皮功能的损伤可能有关。降压治疗可改善原发性高血压患者的内皮功能，降低血清中的FKN 水平。

Correlation between serum Fractalkine and impiared vascular endothelial function in primary hypertension patients

Objective To assess weather Fractalkine is involved in the impaired vascular endothelial function in primary hypertension patients. Methods Fifty primary hypertensive patients and 50 healthy volunteers were recruited. Serum Fractalkine was determined by ELISA. Plasma asymmetric dimethylarginine (ADMA) was determined by high performance liquid chromatography (HPLC). Serum nitric oxide (NO) was determined by nitrate reductase method. Brachial artery flow-mediated vasodilation (FMD) and non-endothelium mediated vasodilation (NMD) were determined by high-frequency ultrasonography. Thirty-eight hypertensive patients (12 of the 50 patients were excluded) received 3 months of standard antihypertensive treatment. Correlations of the Fractalkine change with the changes in NO, ADMA, FMD and systolic pressure levels before and after antihypertensive treatment were evaluated. Results Baseline characteristics of the two groups were similar. Serum Fractalkine level and plasma ADMA level in the primary hypertension group were higher than those in the controls (P < 0.05). FMD and serum NO level in the primary hypertension group were lower than those in the controls (P < 0.05). Fractalkine was positively correlated with ADMA, systolic blood pressure and diastolic blood pressure (r = 0.785, 0.730 and 0.785,P = 0.000), but negatively correlated with NO and FMD (r = -0.800 and -0.783, P = 0.000). After antihypertensive treatment for 3 months, systolic blood pressure, diastolic blood pressure, Fractalkine and ADMA levels decreased,whereas NO and FMD were improved. The decline in Fractalkine level was positively correlated with the decrase of systolic blood pressure, diastolic blood pressure and ADMA, increase of FMD and NO (r = 0.720, 0.405, 0.687, 0.707and 0.726; P = 0.000, 0.012, 0.032, 0.001 and 0.001). Conclusions Fractalkine is a sensitive surrogate marker of endothelial dysfunction in primary hypertension. Antihypertensive therapy improves endothelial function in patients with essential hypertension, and decrease the serum Fractalkine level.