血管内皮功能与运动后血压反应相关性的研究

The responses of blood pressure to exercise stress and changes of endothelium-dependent vasodilatation

目的:研究原发性高血压(EH)患者的内皮依赖性血管舒张功能与运动后血压反应的关系。方法:对53例EH(EH组)患者及42例正常人(对照组),采用高分辨率血管超声进行内皮依赖性血管舒张功能的检测,采用平板运动试验系统进行亚极量运动负荷试验,于运动前、达亚极量负荷后即刻及休息 6 min后测定血压。结果:除2例患者运动前血压≥160/100 mmHg(1 mmHg=0.133 kPa)被除外,其余患者均完成试验。与运动前比较,运动后即刻收缩压在对照组及EH组均显著升高(对照组:P<0.05,EH组: P<0.01),且 EH组的升高幅度较对照组显著(P<0.01),舒张压仅EH组显著升高(P<0.01);运动后6min两组的血压较运动前差异无统计学意义。EH组的内皮依赖性血管舒张功能(FMD%)较对照组显著减低(P<0.05)。运动后舒张压差值与FMD%呈显著负相关( r=-0.809, P<0.01),但收缩压与 FMD%无相关关系( r=-0.296, P>0.05)。结论:运动可使EH患者血压升高,但很快恢复;运动后收缩压升高与内皮依赖性舒张功能无关,而舒张压升高与之密切有关。

Objective:To measure the responses of blood pressure to exercise stress and changes of endothelium-dependent vasodilatation in patients with Essential Hypertension(EH) and Normal persons(Nor). Method:Fifty-three patients with EH and 42 Normal persons were studied. Endothelium-dependent vasodilatation was assessed in the brachial artery by high-resolution ultrasound technique and exercise stress test was assessed by Exercise Stress System. Blood pressure(BP) was measured before ,at the time of exercise and at 6 minutes after exercise. Result:Two patients with EH were not included because of blood pressure being higher than 160/100 mmHg(1 mmHg= 0.133 kPa) before exercise. Immediately after and before exercise stress, there was significant increase of systolic BP(SBP) in both EHs and Nors(Nor:P< 0.05,EH:P< 0.01). However, there was significant increase of diastolic BP(DBP) only in EHs(P< 0.01). There was no significant difference of BP in both EHs and Nors between 6 minutes after and before exercise stress. Compared with Normal persons, FMD% in EHs significantly decreased (P< 0.05). There was significant negative correlation between increasing-range of DBP and FMD%, but not between increasing-range of SBP and FMD%(DBP :r:- 0.809 P< 0.01 ; SBP: r -0.296 P> 0.05). Conclusion: BP obviously increased after exercise but resumed very quickly. Endothelium-dependent vasodilatation is related to change of DBP but not to change of SBP.