高血压病患者脉压指数与血管内皮功能相关性分析

Correlation between Pulse Pressure Index and Endothelial Function in Patients with Hypertension

目的研究高血压病患者的脉压指数(PPI)与血管内皮功能的关系,探讨脉压指数对高血压病临床治疗的指导意义。方法选择高血压病患者120例,检测收缩压(SBP)、舒张压(DBP)、体质量指数(BMI)、空腹血糖(FPG)、TC、TG、HDL-C、LDL-C、Scr、BUN;测定内皮素1(ET-1)、一氧化氮(NO)、血管性假性血友病因子(vWF);测量充血后肱动脉内径变化比(FMD)、含硝酸甘油后肱动脉内径变化比(NMD);按PPI分组,分析各组间各个指标的差异。结果协方差分析(校正年龄)显示:随着PPI的增加,ET-1、ET-1/NO、vWF依次增加,NO、FMD依次减少,NMD无统计学差异;直线相关分析显示:脉压(PP)和PPI均与ET-1、ET-1/NO和vWF正相关,PP和PPI均与NO和FMD负相关。结论 PPI、PP均与血管内皮功能损害有较强的相关性;但是PPI比PP与血管内皮功能损害的相关性更大,对高血压病治疗和预测靶器官损伤更具有指导意义。

Objective To study the relationship between pulse pressure index（PPI） and endothelial function in patients with hypertension,and to explore the clinical significance of PPI in the therapy of hypertension.Methods In this stuy,120 patients with hypertension were enrolled.The systolic blood pressure,diastolic blood pressure,body mass index,fasting plasma glucose,total cholesterol,triglyceride,high-density lipoprotein-C,low-density lipoprotein-C,serum creatinine,and blood urea nitrogen were determined.The endothelin-1（ET-1）,nitric oxide（NO）,and von Willebrand factor（vWF） were measured.The flow-mediated dilatation（FMD） and nitroglycerin-mediated dilatation（NMD） were examined.The patients were divided into 4 groups according to PPI,and the differences among these groups were analyzed.Results After adjusting for age,the analysis of covariance indicated that ET-1,ET-1/NO,and vWF increased and NO and FMD decreased with the increase of PPI and that no significant difference in NMD was found.The linear correlation analysis showed that both pulse pressure（PP） and PPI were positively correlated with ET,ET/NO,and vWF and negatively correlated with NO and FMD.Conclusion Both PP and PPI are closely correlated with endothelial function.PPI is an indicator that is more closely correlated with endothelial function and could guide the therapy of hypertension.