慢性盐负荷对血压正常盐敏感者血管内皮标志物的影响

Effect of chronic salt loading on vascular endothelium markers in normotensive salt-sensitive people

目的观察慢性盐负荷对血压正常盐敏感者的血管内皮标志物的影响。方法以29例血压正常健康自愿者为研究对象,采用慢性盐负荷试验确定血压盐敏感性,观察盐敏感者和盐不敏感者在平衡饮食期、高盐饮食期及低盐饮食期的24 h动态血压、血浆vWF、血、尿一氧化氮(NO)及内皮素-1(ET-1)等血管内皮标志物的变化,综合评价慢性盐负荷对血压正常盐敏感者血管内皮标志物的影响。结果29例血压正常健康自愿者中,检出盐敏感者(SS)11例(37.9%),盐不敏感者(SR)18例;SS组的昼夜平均动脉压差值较SR组显著缩小,高盐负荷后血压显著升高;高盐饮食后,SS组血浆vWF水平显著升高,血、尿NO含量显著减少,而SR组在盐负荷前后变化不著;血浆ET-1在盐负荷前后SS组与SR组之间比较无显著差异。结论部分血压正常个体表现为血压盐敏感性且存在显著的血压昼夜节律性改变;血压正常盐敏感者在高盐负荷时血浆vWF显著升高而血、尿NO含量显著减少,提示血压正常盐敏感者存在高盐介导的血管内皮功能异常。

Objective To investigate the effect of chronic salt loading on vascular endothelium related markers in salt-sensitive subjects with normal blood pressure. Methods Totally 29 volunteers with normal blood pressure were included in this study. Their salt sensitivity （SS） was determined by chronic salt loading testing. We investigated the 24-hour ambulatory blood pressure, plasma yon Willebrand＇ s factor （vWf）, blood and urinary NO metabolites and endothelin-1 （ ET-1 ） concentration during the period of equilibrium, high salt and low salt diet. Results In the 29 normotensive subjects, 11 were determined as SS subjects （37.9%）, and 18 as salt resistant （SR） subjects. When compared with SR group, the SS group showed lower day-night MAP difference in the equilibrium salt load period, in which the blood pressure was significantly elevated after high salt diet. At the end of chronic high salt diet, after high salt loading, SS group＇ s plasma vWF was significantly elevated, and the plasma and urinary NO metabolites was decreased significantly. No significant change was seen in plasma ET-1 between SS and SR group during high salt loading period and equilibrium period. Conclusion Plasma vWF, blood and urinary NO metabolites in the normotensive SS people are significantly altered after high salt loading, which suggests that normotensive SS people may have high salt-mediated endothelial dysfunction.