原发性高血压及高血压合并糖耐量异常患者血管内皮依赖性舒张功能的研究

Changes of endothelium dependent vasodilatation in patients with hypertension and impaired glucose tolerance

目的:探讨原发性高血压及高血压合并糖耐量异常患者血管内皮依赖性舒张功能损伤的变化。方法:对单纯高血压(n=30)、高血压合并糖耐量异常(n=30)患者及正常人(n=20)采用高分辨率超声技术检测血流介导的肱动脉舒张功能(FMD),并分别测定血清一氧化氮(NO)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平。结果:与正常对照组比较,单纯高血压、高血压合并糖耐量异常患者FMD、NO、SOD水平明显下降(P<0.05),MDA的水平明显升高(P<0.05);与单纯高血压组比较,高血压合并糖耐量异常组FMD、NO、SOD水平明显下降(P<0.05),MDA的水平明显升高(P<0.05)。经直线相关分析显示,血清NO、FMD与SOD呈正相关(P<0.05),血清NO、FMD与MDA呈负相关(P<0.05)。结论:原发性高血压及高血压合并糖耐量异常患者血管内皮明显受损,在高血压基础上合并糖耐量异常将进一步导致血管内皮依赖性舒张功能受损。

Obejective：To discuss changes of the endothelium dependent vasodilatation in patients with essential hypertensive and impaired glucose tolerance.Methods：With high-resolution ultrasound flow induced dilation of the brachial artery（FMD）was measured in 30 essential hypertension patients（PH）,30 essential hypertension patients with impaired glucose tolerance（PH＋IGT）and 20 health persons（NH）.Serum nitric oxide（NO）,superoxide dismutase（SOD）and malondialdehyde（MDA）were assayed at the same time.Results：Comparesd with NH group,MDA in PH and PH＋IGT groups increased significantly（P〈0.05）;FMD,NO,SOD in PH and PH＋IGT decreased significantly（P〈0.05）.Compared with PH group,FMD,NO,SOD in PH＋IGT group significantly decreased,MDA markedly increased（P〈0.05）.There was a positive correction between the serum NO,FMD and SOD（P〈0.05）.There was a negative correction between the serum NO、FMD and MDA（P〈0.05）.Conclusion：Patients with essential hypertensive and impaired glucose tolerance had endothelium dependent vasodilatation dysfunction.Impaired glucose tolerance at the base of hypertension can increase this impairment.