代谢综合征对高血压患者血管内皮功能与颈动脉粥样硬化的影响

Endothelial function and carotid atherosclerosis in patients with hypertension complicated by metabolic syndrome

目的探讨代谢综合征(MS)对高血压患者血管内皮功能及颈动脉粥样硬化的影响。方法选取120例高血压患者,根据有无合并MS将其分为2组:MS组(65例)和非MS组(55例),彩色多普勒超声测定肱动脉反应性充血内径、颈动脉内膜厚度及斑块情况。选取健康体检者40名作为对照组(NC组)。结果①MS组的体重指数(BMI)、甘油三酯(TG)、空腹血糖(FPG)均高于非MS组和NC组,P<0.05,P<0.01。②内皮依赖性血管舒张功能(FMD%):MS组明显低于非MS组和NC组[(7.15±2.46)%、(8.45±4.13)%和(12.23±5.12)%,P均<0.05]。③三组颈动脉内膜厚度(IMT)依次为:(0.84±0.21)mm、(0.78±0.24)mm和(0.64±0.14)mm,P均<0.01;颈动脉斑块发生率依次为29.3%、21.8%和5.0%,P均<0.01。④相关分析显示,FMD%与年龄、SBP、TG、FPG呈负相关(r=-0.359、r=-0.357、r=-0.346、r=-0.413,P均<0.01),与HDL-C呈正相关(r=0.341,P<0.01);IMT与年龄、SBP、BMI、TG呈正相关(r=0.431,r=0.442,r=0.315,r=0.342,P均<0.01),与HDL-C呈负相关(r=-0.313,P<0.01)。结论并发MS可加重高血压患者血管内皮功能失调及促进颈动脉粥样硬化的发生。

Objective To explore the damage of metabolic syndrome on endothelial function and carotid atherosclerosis in hypertensive patients. Methods Patients with essential hypertension （EH） were divided into two groups： with metabolic syndrome （MS group,n=65）and non MS group（n=55）, and 40 healthy subjects as control group （NC）. All cases were received echocardiogTaphy and carotid uhrasonogTaphy. Carotid intima-media thickness （IMT） and brachial artery diameter reactive hyperemia were measured. Results （1）Compared with the subjects without MS and NC group,the level of BMI,fasting plasma glucose （FPG）, TG were higher in MS group,P〈0.05, P〈0.01. （2）Endothelium-dependent dilatation （FMD%） were significantly lower in MS group than in non MS and NC group（[（7.15±2.46）% vs （8.45±4.13）% and（12.23±5.12）%,P〈0.05].（3）IMT and the incidences of plaque were significantly higher than in non MS group and NC group （29.3% vs 21.8% and 5.0% ,P〈0.01. （4）FMD% was negatively correlated with age, SBP, TG, FPG （r=-0.359, r=-0.357, r=-0.346, r=-0.413, P〈0.01 ）, and positively correlated with H-DLC （r=0.341,P〈0.01）. IMT was positively correlated with age,SBP,BMI,TG （r=0.431 ,r= 0.442,r=0.315,r=0.342,P〈0.01）. Conclusion Metabolic syndrome further aggravated vascular dysfunction and carotid atherosclerosis in patients with essential hypertension.