A型性格对中老年人内皮功能的影响

Effect of Type-A Character on Endothelial Function in the Elderly

目的:探讨A型性格对中老年人肱动脉血管内皮功能的影响。方法:按照A型性格量表,从正常中老年人中筛选出A型性格组和非A型性格组各60例,采用高频超声检测肱动脉血流介导的血管扩张功能(FMD),其指标用肱动脉舒张内径的变化率(D%)表示;所有入选者均测量身高、体质量并计算体质量指数(BMI),测量收缩压(SBP)、舒张压(DBP),测定空腹血糖(FPG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、一氧化氮(NO)、内皮素(ET)及血管紧张素Ⅱ(AngⅡ)。结果:(1)A型性格组SBP、DBP明显高于非A型性格组(P<0.05);2组FPG、TC、TG及LDL-C差别无统计学意义(P>0.05)。(2)A型性格组较非A型性格组D%及NO明显降低;而AngⅡ及ET明显升高(均P<0.05)。(3)A型行为分值与AngⅡ、ET、SBP、DBP均呈正相关(P<0.05或P<0.01),与D%及NO呈负相关(P<0.05)。经多元线性逐步回归分析,AngⅡ是A型性格的独立危险因素。结论:肾素血管紧张素醛固酮系统的异常激活所导致的AngⅡ增高可能是A型性格中老年人内皮功能异常的主要机制。

Objective：To investigate the effect of type-A character on endothelial function in the elderly. Methods：According to type-A character scale of Zhang Baiyuan, type-A character group and non-type-A character group were screened from the normal elderly, 60 cases for each respectively. Flow-mediated diastolic function of brachial artery was examined by high-frequency echocardiography, which was reflected by diastolic inner diameter changing rate （D %）. Other parameters included height, weight, body mass index （BMI）, systolic and diastolic blood pressure （SBP and DBP）, fasting blood glucose （FPG）, triglyeefide （TG）, total cholesterol （TC）, low-density lipoprotein-cholesterol （LDL-C）, nitric oxide （NO）, endothelin （ET） and angiotensin Ⅱ （Ang Ⅱ ）. All of the parameters and the scores of type-A character were compared and analyzed between the two groups. Results：（1） The levels of SBP and DBP were significantly higher in type A character group than those of non-type A character group （P 〈 0.05）. There were no significant differences in values of FPG, TC, TG and LDL-C between two groups （P 〉 0.05）. （2） The values of D% and NO were significantly lower in type A character group than those of non-type-A character group （P 〈 0.05 ）. The values of Ang Ⅱ and ET were significantly higher in type-A character group than those of non-type-A group （P 〈 0.05 ）. （3）Pearson correlation analysis indicated that the scores of type-A character were positively correlated with Ang Ⅱ, ET, SBP and DBP （P 〈 0.05, P 〈 0.01）, but negatively correlated with D% and NO （P 〈 0.05）. Multiple linear stepwise regression analysis showed that only Ang Ⅱ was an independent risk factor for type-A character. Conclusion：It was showed that the increased Ang Ⅱ induced by abnormal activation of rennin-angiotensin-aldosteerone system （RAAS）may be the main mechanism of endothelial dysfunction in the elderly with type-A character.