高血压病血管内皮功能与颈动脉内-中膜厚度的超声研究

Ultrasonographic study on variations of vascular endothelial function and carotid arterial intima-media thickness in patients with hypertension

目的探讨原发性高血压患者肱动脉内皮功能改变与颈动脉内-中膜厚度的变化及其相互关系。方法研究对象包括24例原发性高血压病患者和18例健康对照者。应用高分辨力超声检测血流介导的肱动脉内皮依赖性舒张功能(EDD)、硝酸甘油介导的肱动脉非内皮依赖性舒张功能(NEDD)以及颈动脉内-中膜厚度(IMT)和斑块。结果高血压病患者EDD明显低于健康对照者(P<0.001),而NEDD两组则无明显不同。颈动脉IMT及颈动脉斑块发生率高血压病组均明显高于对照组(P分别<0.001及<0.05)。颈动脉IMT与肱动脉EDD呈负相关(r=-0.596,P<0.001)。结论高血压病患者存在肱动脉内皮依赖性舒张功能减低及颈动脉粥样硬化,颈动脉内-中膜增厚与肱动脉内皮依赖性舒张功能减低有关。

Objective To access brachial artery endothelium-dependent dilation and carotid arterial intimamedia thickness in pa-tients with hypertension using ultrasonography. Methods Bkood flow mediated endothelium-dependent brachial artery dilation （EDD）, nitroglycerin induced endothelium-independent brachial artery dilation （NEDD）, and carotid arterial intima-media thickness （IMT） and plaques were mearsured by high-resolution ultrasonography in 24 patients with essential hypertension and 18 healthy subjects. Results EDD in patients with hypertension was significantly lower than that in healthy subjects （ P〈 0. 001 ）. No significant difference was found in NEDD between patients with hypertension and healthy subjects. Carotid arterial IMT and the incidence of carotid plaques in patients with essential hypertension were significantly higher than those in healthy subjects （P〈 0.001 and P〈 0.05 respectively）. Carotid arterial IMT showed a significant negative correlation with EDD （ r = - 0. 596, P〈 0.001 ）. Conclusion Brachial endothelium-dependent dilation is impaired and more serious carotid atherosclerosis is found in patients with hypertension. Carotid arterial IMT is associated with impairment of brachial endothelium-dependent dilation.