高血压患者血管内皮功能及颈动脉内膜中层厚度与室间隔厚度的关系

The correlation between vascular endothelial function and carotid intima-media thickness and ventricular septal thickness in patients with hypertension

目的探讨高血压患者室间隔厚度与血管内皮功能及颈动脉内膜中层厚度的关系。方法选择中老年高血压患者85例,应用彩色多普勒超声检测心脏室间隔厚度、肱动脉内皮依赖性舒张功能(FMD)及颈动脉内膜中层厚度(IMT),根据室间隔厚度分为室间隔肥厚组和室间隔正常组,并测定一氧化氮(NO)、内皮素-1(ET-1)、空腹血糖、总胆固醇、低密度脂蛋白等生化指标,同时选择我院体检中心健康人群30名作为健康对照组。结果室间隔肥厚组FMD、NO含量较室间隔正常组及对照组显著降低,颈动脉IMT明显增厚,ET-1浓度明显增高,差异有统计学意义(P<0.05)。相关性分析提示室间隔厚度与IMT(r=0.533)、ET-1(r=0.673)呈正相关,与FMD(-0.628)、NO(r=-0.629)呈负相关,颈动脉IMT与肱动脉FMD呈负相关(r=-0.706)。结论高血压患者存在血管功能障碍,且室间隔肥厚患者血管内皮功能及颈动脉损害程度更严重。

Objective To investigate the relationship and clinical significance between vascular endothelial function and carotid intima-media thickness（ IMT） in hypertensive patients with ventricular septal hypertrophy. Methods Eighty-five hypertensive patients were slected. The carotid intima-media thickness,brachial artery vascular endothelial function and the ventricular septal were detected by ultrasonography. The hypertensive patients were divided into normal septal group and hypertrophy septal group according to the ventricular septal thickness,meanwhile nitric oxide（ NO） 、endothelin（ ET-1） 、fasting blood-glucose（ FBG）,total cholesterol（ TC） 、low-density lipoprotein cholesterol（ LDL-C） were measured. Thirty healthy subjects were selected as control group. Results Compared with the control group and normal septal group,endothelium-dependent vasodilatation function and nitric oxide（ NO） concentration was significantly lower in septal hypertrophy group,moreover,the septal hypertrophy group showed a significant increase of intima-media thickness（ IMT） and ET-1（ P〈 0.05）; pearson correlation analysis indicated that ventricular septal thickness was positively correlated with IMT（ r= 0. 533） and ET-1（ r = 0. 673）,negatively correlated with FMD（- 0. 628） and NO（ r =-0. 629）; What＇s more,a negative correlation was showed between IMT and FMD（ r =- 0. 706）. Conclusion Hypertensive patients have endothelial dysfunction,especially vascular endothelial function and carotid artery.