高血压急症与稳定性高血压患者血管内皮功能及动脉弹性的比较

Impairment of endothelial function and arterial elasticity in patients with hypertensive emergency

目的:通过检测高血压急症患者血管内皮功能及动脉弹性,探讨高血压急症发生的可能机制。方法:在该院急诊科就诊的高血压患者120例,其中高血压急症患者79例,稳定性高血压患者41例。采用高分辨率血管超声法检测患者肱动脉血流介导的血管舒张功能(FMD);应用动脉弹性功能检测仪测定受试者的大动脉弹性指数(C1)和小动脉弹性指数(C2)。结果:高血压急症组FMD明显低于稳定性高血压组[(6.90±4.14)%对比(8.66±4.17)%,P<0.05];高血压急症组与稳定性高血压组的C1比较差异无统计学意义[(11.27±3.77)ml/mmHg(1mmHg=0.133kPa)×10对比(11.57±3.88)ml/mmHg×10,P(0.05],但高血压急症组的C2明显低于稳定性高血压组[(4.48±2.14)ml/mmHg×100对比(5.41±2.35)ml/mmHg×100,P<0.05]。结论:与稳定性高血压患者相比,高血压急症患者FMD降低和小动脉弹性指数损伤更严重。

Objective： To investigate impaired endothelium-dependent vasodilation and arterial elasticity in patients with hypertensive emergency. Methods： One hundred and twenty patients with hypertension （41 patients with stable hypertension and 79 patients with hypertension emergency ） were recruited. Flow-mediated dilation （FMD） in the brachial artery was evaluated by ultrasound Doppler flow method. Pulse wave analysis was introduced for assessment of large artery elasticity index （C1） and small artery index （C2 ）. Results： FMD was significantly reduced in hypertensive emergencies group compared with that in stable hypertension group [ （6.90 ± 4. 14）% vs （8.66 ± 4. 17）%, P 〈 0. 05 ]. There was no significant difference in C, between the two groups （11.27±3.77） ml/mm Hg （1 mmHg=0.133 kPa） ×10 vs （11.57±3.88） ml/mmHg×10, P 〉 0.053 C2 was significantly reduced in hypertensive emergencies group compared with that in stable hypertension group （4. 48 ±2. 14） ml/mm Hg × 100 vs （5.41±2.35） ml/mm Hg× 100, P 〈0.05]. Conclusion： Patients with ypertensive emergency have more severe impairment in C2 and FMD compared with those with stable hypertension.