运动血压与血管内皮功能的相关性研究

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

目的研究正常血压人群的运动血压与内皮功能的关系。方法对82例正常血压者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,然后行活动平板试验,于运动前、达亚极量负荷后即刻及休息6min时测定血压。根据运动高血压的定义将受试对象分为运动高血压组(42例)和运动血压正常组(40例)。比较两组运动血压变化及血管内皮功能差异有无统计学意义。结果与运动血压正常组相比,运动高血压组在吸烟史、饮酒史、高血压家族史方面差异有统计学意义。与运动前比较,运动后即刻收缩压在运动高血压组和运动血压正常组均升高,运动高血压组升高更显著(P<0.01);舒张压在运动高血压组亦升高(P<0.05),而运动血压正常组无明显变化甚至降低。运动后6min血压两组间差异无统计学意义。运动高血压组的内皮依赖性血管舒张功能(FMD%)较运动血压正常组显著减低(P<0.05)。运动后收缩压及舒张压增幅与FMD%呈显著负相关(r=-0.806,P<0.05)。结论运动高血压与内皮依赖性血管舒张功能密切相关。

Objective To study the correlation between stress blood pressure and endothelium dependent vasodilatation in normotensive individuals. Methods Eighty-two normotensive individuals were measured for baseline endothelium dependent vasodilatation in the brachial artery by high-resolution uhrasonography, and then subjected to stress test as assessed by Exercise Stress System. For these participants, blood pressure （BP） was recorded before, immediately after, and at 6 minutes after exercise. The subjects were divided into two groups based on exaggerated BP （EBP） and normal BP （NBP） from exercise test according to definition of exercise-induced high blood pressure. The stress blood pressure and endothelium dependent vasodilatation between the two groups were compared and analyzed. Results Compared with NBP group, EBP group was more likely to have been exposed to cigarette smoking, alcohol use and family history of hypertension. Compared with pre-xercise values, both EBP and NBP groups showed an increase in systolic BP （SBP） immediately after exercise, which was much more greater in the EBP group （P〈0.01）. Moreover, the EBP group also exper/enced significant increase in diastolic BP （DBP） （P〈O.05）, which was unseen in the NBP group. No significant difference in BP was noted between the two groups at 6 minutes. Compared with the NBP group, FMD% in EBP group significantly decreased （P〈O.05）. The increases of post-exercise SBP and DBP from baseline were negatively associated with FMD% （r=-0.806,P〈0.05）. Conclusion Blood pressure response to exercise is related to endothelium dependent vasodilatation.