高血压患者血管生成素2与血管内皮因子及血管舒张功能的关系分析

Relationship between angiopoietin-2 and vascular endothelial factor and vasodilation function in hypertensive patients

目的探讨高血压患者血管生成素2(Ang2)与血管内皮因子及血管舒张功能的关系。方法前瞻性入选初发高血压患者(40例)及健康对照组(25例),检测两组血清Ang2、一氧化氮(NO)、一氧化氮合酶(eNOS),内皮素-1(ET-1);测定高血压患者血流介导血管舒张功能(FMD);对高血压患者降压治疗直至<140/90mmHg(1 mmHg=0.133 kPa)后复查上述指标。结果与对照组比较,高血压组Ang2[(114.0±24.5)与(104.3±14.6)ng/L,P=0.049)与ET-1[(95.7±3.2)与(43.2±3.1)ng/L,P<0.001]水平显著升高,而NO(P<0.001),eNOS(P<0.001)显著降低;与基线相比,高血压组降压治疗后Ang2[(107.1±20.2)ng/L,P=0.049],ET-1[(74.6±23.5)ng/L,P<0.001]显著下降,NO(P<0.001),eNOS(P<0.001)显著升高。降压治疗后的Ang2与对照组差异无统计学意义,但FMD未见统计学差异。相关分析中发现Ang2与平均动脉压(R=0.432,P<0.001)正相关,与NO(R=-0.374,P=0.001)及FMD(R=-0.368 0,P=0.002)负相关。多重线性回归发现Ang2与体重指数、平均动脉压、血清NO独立相关。结论血清Ang 2能够反映高血压患者的内皮和血管舒张功能受损程度,降压治疗可改善内皮功能,但能否恢复受损的血管舒张功能尚需进一步验证。

Objective To analyze the relationship between angiopoietin 2 (Ang2) and vascular endothelial factor and vasodilation function in hypertensive patients.Methods Patients with new onset grade 1~2 hypertension (n=40) and healthy control group (n=25) wereenrolledprospectively.Serum Ang2 and nitric oxide (NO),nitric oxide synthase (eNOS),endothelin-1 (ET-1) were measured in both groups.Flow-mediated vasodilation (FMD) were measured in hypertensive patients.The above indicators were reviewed in hypertensive patients after antihypertensive treatment until blood pressure<140/90 mmHg.Results Compared with the control group,serum Ang2 (P=0.049) and ET-1 (P<0.001) were significantly higher.Serum NO (P<0.001) and eNOS (P<0.001) was significantly lower in the hypertensive group.Compared with baseline,serum Ang2 (P=0.049) and ET-1 (P<0.001) were decreased significantly,meanwhile serum NO (P<0.001) and eNOS (P<0.001) were significantly increased.Serum Ang2 after antihypertensive treatment was not significantly different from that of the control group,but no statistical difference was observed in FMD after antihypertensive therapy.Correlation analysis found that serum Ang2 was positively correlated with mean arterial pressure (R=0.432,P<0.001),and negative correlated with serum NO(R=-0.374,P=0.001) and FMD (R=-0.368 0,P=0.002).Multiple linear regression found that serum Ang2 was independently associated with body mass index,mean arterial pressure,and serum NO.ConclusionSerum Ang 2 can reflect the degree of endothelial and vasodilation impairment in hypertensive patients.Antihypertensive therapy can improve endothelial function,but whether it can restore damaged vasodilation function needs further verification.