高血压患者内皮功能相关分子与颈动脉硬化的相关性

Correlation of Endothelium-Derived Molecule and Carotid Arteriosclerosis in Patients with Essential Hypertension

目的通过测定高血压患者血浆血栓调节蛋白、细胞间粘附分子1和P选择素浓度及颈动脉内膜中膜厚度,旨在探讨高血压患者内皮功能异常在动脉硬化发生中的作用。方法选择原发性高血压患者43例,正常血压者19例,采用酶联免疫吸附法测定血浆血栓调节蛋白、细胞间粘附分子1和P选择素浓度,采用彩色超声系统测定颈动脉内膜中膜厚度。高血压患者按照颈动脉内膜中膜厚度大小又分为颈动脉内膜中膜厚度<0.9 mm组(高血压无颈动脉硬化组)、颈动脉内膜中膜厚度≥0.9 mm组(高血压伴颈动脉硬化组)。结果高血压组颈动脉内膜中膜厚度、血浆血栓调节蛋白、细胞间粘附分子1和P选择素水平显著高于对照组(P<0.05);高血压伴颈动脉硬化组血浆血栓调节蛋白、细胞间粘附分子1和P选择素水平显著高于高血压无颈动脉硬化组(P<0.05);血浆血栓调节蛋白、细胞间粘附分子1和P选择素水平与颈动脉内膜中膜厚度呈正相关。结论高血压患者伴有内皮功能损害,且内皮功能损害与动脉硬化程度相关。

Aim To discuss the correlation of the endothefium-derived molecule and carotid arteriosclerosis through determining the plasma concentration of thrombomodulin （TM）, intercellular adhesion molecule-1 （ICAM-1） and P-selectin and earofid artery infima-meclia thickness （IMT） in patients with essential hypertension. Methods 43 patients with essential hypertension, and 19 healthy subjects were selected. Serum concentrations of TM, ICAM-1 and P-seleetin were measured using enzyme immunoassay method. The carotid artery IMT were determined by ultrasonography. Hypertensive patients were divided into two groups according to IMT thiekness： IMT〈 0.9 mm group （not accompanied with arteriosclerosis） and IMT≥0.9 mm group （accompanied with arteriosclerosis）. Results Carotid IMT, serum levels of TM, ICAM-1 and P-selectin of hypertension group were remarkably higher than control group. Serum levels of TM, ICAM-1 and P-selecfin of group accompanied with arteriosclerosis were remarkably higher than group not accompanied with arteriosclerosis. Serum levels of TM, ICAM-1 and P-selectin were correlated with IMT positively. Conclusions Hypertension can cause endothelium injury. Aterioselerosis can promote endothelium injury.