不同海拔地区高血压患者血管内皮舒张功能及其与氧化应激水平的相关性

Vascular endothelial diastolic function and its correlation with oxidative stress in hypertensive patients at different altitudes

目的探讨不同海拔地区高血压患者血管内皮舒张功能(FMD)及其与氧化应激水平的相关性。方法收集玉树地区(海拔3800m)世居藏族高血压患者及健康对照者各30例(高海拔组),移居西宁地区(海拔2260m)的玉树藏族高血压患者及健康对照者各30例(中度海拔组)。研究对象应用超声血管内皮功能测试仪检查FMD,采用ELISA法测定血清超氧化物歧化酶(SOD)、氧化型谷胱甘肽(GSSG)、一氧化氮(NO)的含量,并对上述结果行相关分析。结果高海拔高血压组FMD、NO、SOD水平低于中度海拔高血压组,差异有统计学意义(P<0.05);高海拔高血压组GSSG水平高于中度海拔高血压组,差异有统计学意义(P<0.05);高海拔高血压组FMD、NO、SOD水平低于高海拔健康对照组,差异有统计学意义(P<0.05);高海拔高血压组GSSG水平高于高海拔健康组,差异有统计学意义(P<0.05);高海拔健康对照组FMD、NO、SOD水平低于中度海拔健康对照组,差异有统计学意义(P<0.05);高海拔健康对照组GSSG水平高于中度海拔健康对照组,差异有统计学意义(P<0.05)。经Pearson相关分析显示,高海拔高血压组FMD与GSSG水平呈负相关(r=-0.863,P<0.01),与SOD、NO水平呈正相关(r=0.842,P<0.01;r=0.887,P<0.01)。中度海拔高血压组FMD与GSSG水平呈负相关(r=-0.852,P<0.01),与SOD、NO水平呈正相关(r=0.822,P<0.01;r=0.861,P<0.01)。结论不同海拔地区高血压患者血管内皮功能下降,氧化应激水平升高,但具有差异性:随海拔的升高,机体抗氧化能力下降,脂质过氧化反应增强。

Objective To investigate the relationship between flow-mediated dilation ( FMD) and oxidative stress in hypertensive patients at different altitudes.Methods 30 Tibetan hypertension patients and 30 healthy controls in Yushu area( altitude 3800m),30 Tibetan hypertension patients and 30 healthy controls in Xining area( altitude 2260m) were collected.FMD was examined by ultrasound endothelial function tester,and serum levels of the oxidized glutathione( GSSG),superoxide dismutase( SOD) and nitric oxide( NO) were determined by ELISA.Results The levels of FMD,NO and SOD in high altitude hypertension group were lower than those in moderate altitude hypertension group,with statistical significance( P<0.05);the levels of GSSG in high altitude hypertension group were higher than those in moderate altitude hypertension group,with statistical significance( P<0.05);the levels of FMD, NO and SOD in high altitude hypertension group were lower than those in high altitude healthy control group,with statistical significance( P<0.05).The level of GSSG in high altitude hypertension group was higher than that in high altitude health group,with statistical significance( P<0.05);the level of FMD,NO and SOD in high altitude health control group was lower than that in moderate altitude health control group,with statistical significance( P<0.05);the level of GSSG in high altitude health control group was higher than that in moderate altitude health control group,with statistical significance( P<0.05).Pearson correlation analysis showed that FMD was negatively correlated with GSSG level( r =-0.863,P<0.01) and positively correlated with SOD and NO level in high altitude hypertension group( r = 0.842,P<0.01;r = 0.887,P<0.01).FMD was negatively correlated with GSSG level( r =-0.852,P<0.01) and positively correlated with SOD and NO level in moderate altitude hypertension group ( r = 0. 822,P < 0. 01;r = 0.861,P<0.01).Conclusion The vascular endothelial function of hypertensive patients decreases and the level of oxidative stress increases under hypoxic conditions at different altitudes.there are shown differenceswith the increase of altitude,the body's antioxidant capacity decreased and lipid peroxidation increased.