高血压病患者血管内皮依赖性舒张功能与血清一氧化氮和超氧化物歧化酶的关系

The Relationship between Endothelium-Dependent Vasodilataion Function and Serum Nitric Oxide and Superoxide Dismutase in Patients with Essential Hypertension

为探讨高血压病患者血管内皮依赖性舒张功能和血清一氧化氮和超氧化物歧化酶的变化及其相互关系 ,采用高分辨率超声技术 ,对 2 8例高血压病患者和 2 8例正常对照者的血管内皮依赖性和非依赖性舒张功能进行检测 ,同时测定血清一氧化氮和超氧化物歧化酶水平。结果发现高血压病患者反应性充血肱动脉内径舒张率显著低于对照组 (6 .33%± 2 .5 9%比 13.14 %± 4 .2 4 % ,P <0 .0 0 1) ,而含服硝酸甘油后肱动脉内径舒张率在两组间无显著性差异 (P >0 .0 5 )。与正常对照组相比 ,高血压病组血清一氧化氮和超氧化物歧化酶水平明显下降 (5 3.5 5± 2 3.5μmol/L比 83.2 6± 2 3.2 5 μmol/L ,86 .5 7± 2 6 .6 6kNU/L比 117.1± 33.6 4kNU/L ,P <0 .0 0 1)。单因素相关分析显示血管内皮依赖性舒张功能与年龄、收缩压、舒张压呈负相关 ,相关系数r分别为$C 0 .36 6 (P <0 .0 1)、$C0 .6 5 (P <0 .0 0 1)、$C 0 .6 72 (P <0 .0 0 1) ,与血清NO和SOD呈正相关 ,相关系数r分别为 0 .838(P <0 .0 0 1)、0 .6 83(P <0 .0 0 1) ,而多元逐步回归分析仅显示血管内皮依赖性舒张功能与舒张压呈负相关 ,与血清一氧化氮和超氧化物歧化酶呈正相关。提示高血压病患者存在血管内皮依赖性舒张功能障碍 。

Aim To study the changes in endothelium dependent vasodilation function,serum nitric oxide (NO) and superoxide dismutase (SOD) and their inter relationships in patients with essential hypertension (EH). Methods High resolution B mode ultrasonography was used to measure the endothelial dependent vasodilation in 28 patients with EH and 28 matched healthy subjects. Serum levels of NO and SOD were also measured. Results The increased percentage of the brachial artery diameter after reactive hyperemia was lower in patients with EH than that of normal controls (6.33%±2.59% vs 13.14%±4.24% P<0.001), whereas nitroglycerin induced changes were similar (P>0.05). Serum levels of NO,SOD in patients with EH was significantly lower compared with those in controls (53.55±23.5 μmol/L vs 83.26±23.25 μmol/L,86.57±26.66 kNU/L vs 117.1±33.64 kNU/L,P<0.001). Correlation analysis shows that endothelium dependent vasodilation function was negatively correlated with ages,systolic blood pressure,dilated blood pressure,the coefficients were -0.366 (P<0.01),-0.65 (P<0.001),-0.672 (P<0.001),and was positively correlated with serum NO and SOD,the coefficients were 0.838 (P<0.001),0.683 (P<0.001). The analysis of multiple stepwise regression shows that the endothelium dependent vasodilation function was negatively correlated with dilated blood pressure and positively correlated with serum NO and SOD. Conclusion Our findings support that endothelium vasodilation is impaired and was correlated with reduction of NO and increase of active oxygen species.