高血压、糖尿病联合作用加重血管舒张功能受损(英文)

Interaction of hypertension and diabetes on impairment of endothelial function

目的 评价血管平滑肌功能 (硝酸甘油引起的血管舒张 )不全与内皮功能不全的联系并探讨糖尿病与高血压对内皮功能的损害是否具有协同作用。方法 用高分辨率超声波仪测定肱动脉对硝酸甘油 (NTG)的扩张反应及血流介导的内皮依赖性血管舒张(EDD)。结果 平滑肌功能受损与受损的EDD呈正相关 (r =0 54,P <0 0 0 1)。单纯糖尿病或高血压仅EDD较对照组降低 ( 5 74 %± 3 32 % ;4 14%± 2 93%对 9 4 5%± 3 88% ,P分别 <0 0 5及 0 0 1) ,糖尿病合并高血压组不仅EDD受损 ( 2 78%± 2 0 8% ,P <0 0 0 1) ,平滑肌功能也受损 ( 14 11%± 4 63对 2 3 53%± 6 77% ,P <0 0 0 1)。结论 导致血管内皮功能不全的病理过程可能也同样损害血管平滑肌功能。 2型糖尿病与高血压相互作用加重血管舒张功能不全。

Objective To investigate whether the interaction of hypertension and diabetes aggravates endothelial dysfunction and leads to smooth muscle dysfunction. Methods Noninvasive methods were used to the investigated patients with type 2 diabetes mellitus (2-DM) (Group 1), patients with hypertension (Group 2) and patients with both 2-DM and hypertension (Group 3), as well as a normal control group (Group 4) by studying a brachial artery without evidence of atherosclerotic plaque formation. Results Results showed that endothelium-dependent vasodilation decreased significantly in Group 1 (5.74%±3.32%, P<0.05), Group 2 (4.14%±2.93%, P<0.01), and Group 3 (2.78%±2.08%, P<0.001) as compared to the control (9.45%±3.88%). The nitroglycerin-induced vasodilation (smooth muscle function) in Group 3 was significantly decreased as compared to the control group (14.11%±4.63% vs 23.53%±6.77%, P<0.001), but there were no differences in nitroglycerin-induced vasodilation between Group 1, Group 2 and Group 4. On univariate analysis, a reduced vasodilator response to nitroglycerin was associated with endothelium-dependent vasodilation (r=0.54, P<0.001). Conclusion Our results indicate that the interaction of 2-DM and hypertension aggravates endothelial dysfunction and further impairs the smooth muscle function.