高血压病患者球结膜微血管改变与血管内皮细胞的关系

The Relationship Between Microvascular Alterations of Bulbar Conjunctiva and Vascular Endothelial Cells in Patients with Essential Hypertention

目的探讨高血压病患者微血管改变与血管内皮细胞间的关系。方法选择高血压病Ⅱ期患者50例 ,随机分为两组 ,分别用L-精氨酸 (L-arg)、巯甲丙脯酸(CPT)治疗 ,观察治疗前后球结膜微血管改变 ,检测血浆内皮依赖性舒张因子 (EDRF)、血浆内皮素 (ET)和循环内皮细胞计数 (CEC) ,并与25例正常人作对照。结果两治疗组治疗后血压均较治疗前下降 (P<0.05～0.001) ,A/V比值增大 (P<0.05～0.005) ,缺血区减少 (P<0.05～0.001) ,EDRF增高(P<0.05～0.005) ,ET下降(P<0.02～0.01) ,L-arg组治疗后CEC减少 (P<0.05)。结论L-arg和CPT均可有效地减少EH患者的缺血区 ,扩张微动脉 ,这与其改变血管内皮细胞 (VEC)结构和功能有关。

Objective To study the relationship between microvacular alterations and vascular endothelial cells in patients with essential hypertebsion (EH).Methods Fifty cases of EH at stage Ⅱwere randomly divided into 2 groups:L_Arginine (L_Arg) group which was treated with L_Arg for 10 days,and captopril (CPT) group which was treated with CPT for 10 days. The changes of microvasculature of the bulbar conjunctiva, the plasma concentration of the endothelium derived relaxing factor (EDRF), endothelin(ET) and the counts of circular endothelial cells (CEC) were determined in 2 groups before and after treatment.Twenty_five healthy sbjects were served as control group.Results After treatment, blood pressure, the number of ischemic areas and the concentration of ET decreased, the ratio of arteriole diameter and venule diameter (A/V) and the concentration of EDRF increased in both L_Arg group and CPT group (vs.Pre_treatment). The count of CEC was lower after treatment than it was before treatment in L_Arg group. Conclusions L_Arg and CPT can effectively reduce ischemic areas and dilate arterioles by improving structure and function of vascular endothelial cells in patients with EH.