单纯收缩期高血压患者血清晚期糖基化终产物与血管功能的关系

Relationship between Advanced Glycation End Products and Vascular Function in Patients with Isolated Systolic Hypertension

目的探讨晚期糖基化终末产物(AGEs)与血流介导的内皮依赖性血管舒张功能(FMD)间的关系及其致血管功能异常的作用。方法选择单纯收缩期高血压(ISH)患者120例作为ISH组,双期高血压患者120例作为双期高血压(DH)组,年龄配对的健康人群70例作为正常对照组,采用日本科林公司生产的VP1000动脉硬化检测仪测定颈股动脉脉搏波传导速度(cfPWV),超声技术测定FMD,ELISA检测受试者外周血清中AGEs和内皮素1,Griess法测定外周血中一氧化氮含量。结果ISH组的cfPWV、AGEs、内皮素1高于DH组及正常对照组(P<0.05);ISH组及DH组FMD、一氧化氮低于正常对照组(P<0.05),而FMD、一氧化氮在ISH组及DH组间差异无统计学意义;AGEs与cfPWV、内皮素1呈正相关(r=0.525,P<0.01;r=0.863,P<0.01);AGEs与FMD、一氧化氮呈负相关(r=-0.635,P<0.01;r=-0.669,P<0.01);多元逐步回归分析显示AGEs、cfPWV是FMD的危险因素。结论AGEs是导致血管功能异常的危险因素,可能在ISH的发生发展过程中起一定作用。

Objective To investigate the correlation between advanced glycation end products （AGEs） and endothelium dysfunction defined by flow-mediated vasodilatation （FMD） and in patients with isolated systolic hypertension.MethodsOne hundred and twenty patients with isolated systolic hypertension （ISH）, 120 patients with systolic-diastolic hypertension （DH） and 70 aged-matched NT （normotension control） subjects were recruited.Pulse wave velocity （PWV） and FMD were determined.Serum AGEs, ET-1 were measured by ELISA, and NO by Griess＇ method.ResultsThe PWV, AGEs and ET-1 were significantly higher in ISH patients compared with NT controls and DH patients, while FMD and NO in ISH patients and DH patients were markedly lower than those in NT controls.AGEs was significantly positively correlated with PWV and ET-1 （r=0.525, P〈0.01; r=0.863, P〈0.01）, but negatively correlated with FMD and NO （r=-0.635, P〈0.01; r=-0.669, P〈0.01）.Multiple linear regression analysis showed AGEs, cfPWV were risk factors for impaired FMD.ConclusionAGEs was the risk factor of endothelium dysfunction, and may be involved in the development of ISH.