青少年隐性高血压患者的血管内皮功能变化及其相关危险因素

Changes of vascular endothelial function and its related risk factors in teenagers with masked hypertension

目的探讨青少年隐性高血压(MH)患者的肱动脉内皮功能变化及其相关危险因素。方法根据动态血压和诊室测量血压筛选30例MH青少年患者(MH组)和30例正常血压青少年(对照组),所有入选者均测量身高、体质量、体质量指数(BMI)和腰臀比,检测空腹血糖(FBG)、血脂、血清一氧化氮(NO)和血管假性血友病因子(vWF)水平,应用彩色多普勒超声测定肱动脉舒张功能。结果 MH组青少年BMI显著高于对照组(P<0.05),2组青少年身高、体质量及腰臀比比较差异均无统计学意义(P>0.05)。MH组青少年低密度脂蛋白胆固醇水平显著高于对照组,差异有统计学意义(P<0.05),2组青少年三酰甘油、总胆固醇、高密度脂蛋白胆固醇及FBG比较差异均无统计学意义(P>0.05)。MH组青少年肱动脉血流介导的舒张显著低于对照组,差异有统计学意义(P<0.05),2组青少年肱动脉基础内径、硝酸甘油介导的舒张及血流速度比较差异均无统计学意义(P>0.05)。MH组青少年血清NO水平显著低于对照组,vWF水平显著高于对照组,差异有统计学意义(P<0.05)。结论青少年MH患者存在内皮舒张功能障碍;BMI升高和血清低密度脂蛋白胆固醇水平降低可能是MH的危险因素。

Objective To observe the changes of brachial artery endothelial function and its related risk factors in ado- lescents with masked hypertension （MH）. Methods Thirty adolescents with MH （ MH group） and thirty adolescents with nor- mal blood pressure （control group） were selected according to the dynamic blood pressure and blood pressure of consulting room. The body height,body weight,body mass index（BMI） and waist-to-hipratio were measured in all subjects. The levels of fasting blood glucose（FBG） ,blood fat,nitric oxide（NO） and yon Willebrand factor（vWF） were detected. The brachial artery diastolic function was detected with color Doppler ultrasound. Results The BMI of adolescents in MH group was significantly higher than that in control group（ P 〈 0.05 ）. There was no significant difference in the body height, body weight and waist-to- hipratio between the two groups（ P 〉 0.05 ）. The level of low density lipoprotein-cholesterol in MH group was significant higher than that in control group（P 〈 0.05 ） ;but there was no significant difference in the levels of triacylglycerol, total cholesterol, high density lipoprotein-cholesterol and FBG between the two groups （P 〉 0.05）. The flow mediated dilation in MH group was significantly lower than that in control group（ P 〈 0.05 ） ;but there was no significant difference in the basal inner diameter of brachial artery, nitroglycerin-mediate dilation and blood flow rate between the two groups （ P 〉 0.05 ）. The serum NO level in MH group was significantly lower than that in control group （ P 〈 0.05 ） , and the vWF level in MH group was significantly higher than that in control group （ P 〈 0.05 ）. Conclusion Adolescents with MH have endothelial diastolic dysfunction ; the increasing BMI and reducing serum LDL-C level may be the risk factors for MH in adolescents.