高血压病人血浆和肠系膜动脉平滑肌细胞中NO与ET-1的变化

Changes of nitric oxide and endothelin in the plasma and mesenteric smooth muscle cells in patients with essential hypertension

目的：探讨一氧化氮（ＮＯ），内皮素（ＥＴ）在原发性高血压（ＥＨ）发病机理中的作用。方法：选择因腹部手术住院的患者１８例，其中ＥＨ患者９例，正常血压（ＮＴ）患者９例，检测血浆ＮＯ，ＥＴ水平，取肠系膜动脉行分离、消化后作血管平滑肌细胞（ＶＳＭＣ）培养，用一氧化氮合成酶阻断剂ＮＧ－单甲基－Ｌ－精氨酸（Ｌ－ＮＭＭＡ）干预，再检测培养上清ＮＯ、ＥＴ水平。结果：ＥＨ组血浆及ＶＳＭＣ培养上清中ＮＯ水平较ＮＴ组低，而ＥＴ水平较ＮＴ组高，Ｌ—ＮＭＭＡ可以促进ＶＳＭＣ分泌ＥＴ（Ｐ＜０．０１）。结论：ＥＨ患者血管张力增高，可能与局部血管组织中ＮＯ产生较少，ＥＴ产生较多，且ＮＯ对ＥＴ的抑制作用减弱有关。

Objective: To explore the role of nitric oxide (NO) and endothelin (ET) in the pathogenesis of essential hypertension (EH). Methods: Eighteen patients undergone abdominal operation including 9 with EH and 9 without EH were selected, the levels of NO and ET in the plasma were measured. The mesenteric artery was then isolated and digested for culture of the vascular smooth muscle cells (VSMCs). The cultured VSMCs were treated with NGmonomethylLarginine (LNMMA), the inhibitor of NO synthase. Finally, the levels of NO and ET in the supernatant of cultured VSMCs were also measured. Results: The level of NO was significantly lower but that of ET was significantly higher in the plasma and supernatant of cultured VSMCs in patients with EH than in those without EH (P<0.01 and P<0.05～0.01). LNMMA significantly increased ET level in all patients (P<0.01). Conclusion: The higher vascular tone and blood vessel resistance in patients with EH might be due to decrease of NO and increase of ET.