血压盐敏感者早期血管内皮功能改变研究

Vascular endothelial function in salt sensitive and non-salt sensitive subjects

目的 盐敏感者较早出现靶器官功能损害,其心血管风险增加.本研究探讨血压正常或血压轻度偏高的盐敏感者血管内皮功能改变.方法 选99例年龄16～60岁、血压正常或血压轻度偏高者参与为期2周的慢性盐负荷试验,检测盐敏感性.试验包括基线3 d,低盐饮食、高盐饮食各7 d的研究.基线时采用彩色多普勒超声检测血流调节的血管扩张性,反映内皮依耐性血管舒张功能.试验各个阶段测量体重、血压,并收集血、尿标本.结果 盐敏感者检出率17.2%,盐敏感与盐不敏感者基线尿钠、钾排泄量无差异,而血浆NO浓度盐敏感者低于盐不敏感者[（61. 2±13.3）μmol/L比（82.5±14.6）μmol/L,P＜0.05];盐敏感者血流介导的肱动脉扩张性低于盐不敏感者[（10.2±2.5）%比（14.5±1.6）%,P＜0.05].结论 盐敏感者尽管尚处在血压正常或血压轻度偏高阶段已存在内皮功能损伤.

Objective Salt-sensitivity is associated with more severe target organ injury and higher mortality in patients with essential hypertension. We compared the vascular endothelial function between saltsensitive subjects（SS）and non-salt-sensitive subjects（NSS）with normal or mildly increased blood pressure. Methods Ninety-nine subjects（aged 16-60 years）with normal blood pressure or mild hypertension（degree 1）were enrolled. The test program included 3 days baseline investigation, 1 week lowsalt loading phase and 1 week high-salt loading phase. Endothelial function was assessed by measuring the flow mediated dilatation（FMD）of the brachial artery using high resolution ultrasound. Results There was 17. 2% SS. Plasma NOx level[（61.2 ± 13. 3）μmol/L vs（82. 5 ± 14. 6）μmol/L, P 〈 0. 05]and FMD [（10.2±2.5）%vs（14.5 ± 1.6）%, P 〈0.05]were significantly lower in SS subjects than in NSS subjects. Conclusion Vascular endothelial dysfunction was evidenced in SS subjects with normal blood pressure or in the early stage of hypertension.