原发性低血压心功能指标与血浆内皮素、一氧化氮关系的研究

Research on the Cardiac Function and the Level of Nitric Oxide and Endothelin in the Essential Hypotension Patients

目的:通过检测原发性低血压患者的心脏功能指标,血浆内皮素、一氧化氮水平,探讨二者之间的关系及原发 性低血压的发病机制。方法:原发性低血压组50例,对照组20例,分别采用彩色超声心动图检测心脏功能指标及 放射免疫法测定血浆内皮素、一氧化氮水平。结果:心功能检测显示:①原发性低血压患者的室间隔厚度(IVST)、 左室重量(LVM)、左室重量指数(LVMI)及平均舒张期室壁厚度(MWTD)均较正常组明显减少,左室收缩末内径 (LVDS)、左室舒张末内径(LVDD)较正常组明显增加,P<0.01。②低血压组的左室射血分数(EF)、左室短轴缩短 率(FS)、左室收缩末室壁应力(ESS)及心肌收缩性均较正常组明显降低,其中EF值仍处正常值范围。③低血压组 的舒张早期减速度(DC)较正常组明显减低,P<0.01。原发性低血压组一氧化氮(NO)水平高于正常组,P<0.01, 内皮素(ET)水平显著高于正常组,P<0.05,NO与ET比值较对照组有显著差异P<0.05。结论:原发性低血压 患者的心脏舒缩功能较正常组有相对减弱的趋势,血浆一氧化氮、内皮素的改变可能参与原发性低血压的发病。

Objective:To observe the essential hypotension patients' cardiac function and the level of Nitric oxide and endothelin in serum; to investigate the relationship between both and the pathogen of the Essential Hypotension Patients.Methods:The Essential Hypotension Patients group 50 cases,the control group 20 cases,to detect the cardiac function by the echocardiogram and the level of Nitric oxide and endothelin in serum by radioimmunology.Result:The detection of cardiac function by echocardiogram showed that:①The patients' Interventricular Septal Thickness(IVST)、Left Ventricular Mass(LVM)-Left Ventricular Mass Index(LVMI)and Mean Wall Thickness at Diastole(MWTD)decreased significantly,while the left ventricular internal diameter at end-systole(LVDs)and the left ventricular internal diameter at end-diastole(LVDd)decreased,P<0.01.②The patients' left ventricular ejection fraction(EF)、FS、end-systolic stress on the left ventricular wall(ESS)and the cardiac contractility descended obviously, but the EF was still in the normal field.③The patients' early-diastolic deceleration(DC) descended significantly,P<0.01.There was no difference in statistics of the cardiac diastolic function. The level of NO was higher than the control group(P<0.01),The level of ET and the ratio of NO/ET were higher than the control group too(P<0.05,P<0.05).Conclusion:The Essential Hypotension Patients' cardiac function decreased, the changes of ET and NO maybe one of the pathogenesis of the Essential Hypotension Patients.