高血压病人血管内皮标志物与内皮依赖性血管舒张功能的关系

The Relationship of Vascular Endothelial Marker and Endothelium-Dependent Vasodilatation in Patients with Essential Hypertension

目的:探讨高血压病人血管内皮标志物与内皮依赖性血管舒张功能的关系。方法:用放射免疫分析和酶联荧光免疫法检测56例高血压病人和32例正常对照组血浆内皮素(ET-1)和血管性假血友病因子(vWF),并用高分辨彩色多谱勒超声仪检测肱动脉内皮依赖性血管舒张功能。56例高血压病人按危险度分层,分为低/中危险度30例,高/极高危险度26例;其中50例用药物治疗后复查血浆ET-1、vWF和肱动脉内皮依赖性血管舒张功能。结果:高血压组血浆ET-1、vWF水平显著高于正常对照组[(53.3±16.2)pg/ml vs(42.5±8.5)pg/ml,(158.2±28.6)%vs(130.6±35.2)%],高/极高危组明显高于低/中危组(P<0.001);高血压组肱动脉反应性充血诱导下血管内径舒张率较正常对照组明显减弱(7.5±4.2)%vs(12.3±4.3)%,高/极高危组明显高于低/中危组(P<0.001),低/中危组也较正常对照组明显减弱(P<0.05)。经抗高血压药物治疗后,血浆内皮标志物和内皮依赖性血管舒张功能明显改善。相关分析显示,血浆内皮标志物和内皮依赖性血管舒张功能存在显著的负相关关系(P<0.01)。结论:高血压病人存在血浆vWF、ET-1水平升高和内皮依赖性血管舒张功能障碍,且与靶器官的损伤相关;血浆内皮细胞标志物可反映内皮依赖性血管舒张功能。

Objective To explore the relationship of vascular endothelial marker and endothelium-dependent vasodilatation in patients with essential hypertension（EH）.Methods Plasma endothlium（ET-1）（with RIA） and von Willber factor（vWF）（with ELISA） levels were measured both before and after 12 wks＇ treatment in 56 patients with essential hypertension and 32 controls.The brachial artery endothelium-dependent vasodilatation function was examined with high resolving color doppler ultra-sonography.The 56 patients with EH were of two groups A.high and very high risk,n=26 B.low and moderate risk,n=30.Results Plasma levels of ET-1,vWF in patients with EH as a whole were significantly higher than those in controls group [（53.3±16.2）pg/ml vs（42.5±8.5）pg/ml,（158.2±28.6）% vs（130.6±35.2）%],endothelium-dependent vasodilatation function wasmuch reduced in patients with EH（7.5±4.2）% vs controls（12.3±4.3）%.Among the patients,values in Group A were significantly different from those in Group B.After treatment for 12 weeks,plasma ET-1 and vWF and endothelium-dependent vasodilatation function were significantly improved.There was negative correlation between vascular endothelial marker levels and endothelium-dependent vasodilatation function.Conclusion The endothelium-dependent vasodilatation function was impaired and plasma ET-1 and vWF levels were increased in patients with EH,the endothelial dysfunction was closely associated with the risk level of EH.Vascular endothelial markers were useful indicators for evaluation of the endothelium-dependent vasodilatation function.