高血压盐敏感者血管性血友病因子与尿内皮素-1及动态血压的关系

Circulating levels of von Willebrand factor and its relation with urinary endothelin-1 excretion and ambulatory blood pressure in salt sensitive hypertensive patients

目的 探讨盐敏感性高血压患者血浆血管性血友病因子 (vWF)水平与尿内皮素 1(ET 1 )及动态血压的关系。方法 32例原发性高血压患者和 2 1例血压正常自愿者用急性静脉盐水负荷试验确定盐敏感者 ,并检测血浆vWF水平、尿ET 1排泄量、尿钠排泄量及血压。结果 盐敏感性高血压患者血浆vWF水平显著高于盐不敏感者 ,盐水负荷后 4h盐敏感性高血压患者血浆vWF水平较盐负荷前显著增加 ,尿ET 1排泄量在盐敏感性高血压患者显著低于盐不敏感者 (P <0 .0 1 )。盐敏感性高血压患者盐负荷后尿钠排泄明显减少 ,血浆vWF与尿ET 1呈负相关 ,与动态血压水平呈正相关。结论 盐敏感性高血压患者存在明显内皮功能障碍 ,并与尿ET 1排泄减少及较高血压水平有关。

Objective To investigate the plasma vWF levels and its relation with urinary ET 1 and ambulatory blood pressure in salt sensitive hypertensive patients. Methods Thirty two cases of mild to moderate hypertensive patients and 21 cases of normotensive volunteers were recruited in this study.We determined salt sensitivity by acute venous saline loading test and examined the plasma vWF levels,urinary endothelin 1 excretion,urinary sodium content and ambulatory blood pressure levels.Results The circulating levels of vWF were elevated significantly in salt sensitive hypertensive patients when it was compared to salt resistant subjects and increased more while salt sensitive hypertensive subjects took saline loading.On the contrary,the urinary ET 1 excretion was lower in salt sensitive patients than that in salt resistant patients and the sodium excretion were reduced in salt sensitive patients while saline loaded.In addition,the circulating vWF was in negative correlation with urinary ET 1 excretion and positive with ambulatory blood pressure.Conclusion These data suggested that salt sensitive hypertensive patients exist obvious endothelial dysfunction and may be in relation with urinary ET 1 and ambulatory blood pressure.