原发性高血压合并糖耐量减低患者脉搏波传导速度与内皮功能的变化

Changes in pulse wave velocity and endothelium function in essential hypertension patients with impaired glucose tolerance

目的探讨原发性高血压(essential hypertension,EH)合并糖耐量减低(impaired glucose tolerance,IGT)患者脉搏波速度(pulse wave velocity,PWV)的变化,并分析其与一氧化氮(nitric oxide,NO)及内皮素(endothe-lin,ET)的相关性。方法对正常对照组(A组,n=42)、单纯高血压组(B组,n=40)及高血压合并糖耐量减低组(C组,n=45),分别测定臂踝脉搏波传导速度(baPWV)、血清NO、ET水平。结果与A组比较,B、C组血NO水平明显下降(P<0.05),baPWV及ET水平明显增高(P<0.05);与B组比较,C组血NO水平明显下降(P<0.05),baPWV及ET水平明显升高(P<0.05)。经直线相关分析显示,C组baPWV与血清NO水平呈负相关(P<0.05),与血清ET水平呈正相关(P<0.05),baPWV与年龄、脉压(pulse pressure,PP)及餐后2 h血糖(2-hourpostprandial blood glucose,2hPG)也明显相关(P<0.05)。结论原发性高血压患者血管内皮功能明显受损,在高血压基础上糖耐量异常将进一步使血管内皮功能受损和动脉僵硬度增加。

Objective To investigate the changes in pulse wave velocity（PWV） in essential hypertension（EH） patients with impaired glucose tolerance（IGT）,and to analyze the correlation of PWV with nitric oxide（NO） and endothelin（ET）.Methods The levels of baPWV,NO and ET in serum were measured in normal control group（Group A,n=42）,simple hypertension group（Group B,n=40） and hypertension combined with IGT group（Group C,n=45）.Results Compared with those in Group A,NO level in serum was significantly reduced,with increased baPWV and ET in Group B and C（P〈0.05）.Compared with those in Group B,NO level in serum was significantly reduced,with increased baPWV and ET in Group C（P〈0.05）.Significantly negative and positive correlations were revealed between baPWV and NO,and between baPWV and ET,respectively,in Group C according to linear correlation analysis（both P〈0.05）.Meanwhile,baPWV was significantly correlated with age,pulse pressure and 2-hour postprandial blood glucose（all P〈0.05）.Conclusion Vascular endothelium function is obviously impaired in EH patients.The endothelial injury and stiffness of arteries are exacerbaeted by IGT in these patients.