超声检测高血压病人血管内皮依赖性舒张功能

Endothelium_dependent Relaxation Assessed with Ultrasound Image in Patients with Hypertension

采用Celermajer等的方法对照观察高血压(EH)患者在休息时、反应性充血 ,再休息以及含服硝酸甘油后肱动脉内径和血流的变化 ,以评价高血压患者血管内皮依赖性舒张功能的变化。方法采用高分辨超声技术 ,对51例EH患者和35例正常对照者的血管内皮依赖性舒张功能进行测定评价 ,并测定其血浆一氧化氮(NO) ,内皮素(ET)血栓素B2(TXB2)和前列腺环素(PGI2)等血管活性物质的浓度变化。结果发现EH组肱动脉血流介导的血管舒张(FMD)较正常组明显减弱(5.70 %±1.6 %和10.2 %±2.7 % ,P<0.001) ,而两组对硝酸甘油的反应无显著性差异(19.8%±6.4 %和20.8 %±6.9 % ,P>0.05)。EH组血浆NO ,PGI2 水平较正常组低(分别为15.4±6.13 ,45.6±8.21与26.4±7.8,89.4±19.8。P<0.01)。结论EH患者存在血管内皮依赖性舒张功能受损 ,超声是评价血管内皮依赖性舒张功能的简便、无创、可靠的方法。

Objective To assess the endothelium_dependent relaxation in patients with hypertension with high_resolution utrasound and Celermajer's method. Methods With high_resolution ultrasound, we measured endothelium_dependent relaxing function in 86 subjects:51 of them with hypertension and the others as normal control. We measured the meter of the superficial femoral and brachial arteries at rest, during reactive hyperaemia,re_rest and after sublingual glyceryl trinitrate; causing endothelium_independent dilation in subjects. The level of plasma NO, ET, PGI2,and TXB2 were determined. Results There was significantly smaller flow_mediated dilatation in the HP patients than in normal persons. By contrast, dilatation to GTN did not differ from that in control subjects. The concentration of plasma NO and PGI2 wrer lower than normal control. Conclusions Endothelium_dependent dilation was impaired in patients with hypertension. High_resolution ultrasound image can be successfully used in assessing endothelium_dependent dilation. It was a simple, non_invasive and reliable technique.