应用高频超声对高血压及高血压伴吸烟患者血管内皮舒张功能的研究

目的　应用高分辨超声技术对原发性高血压及高血压伴吸烟患者的内皮依赖性血管舒张功能进行研究和分析。方法　采用高频超声技术 ,对 6 3例患者其中 2 2例原发性高血压 (EH) ,2 2例高血压伴吸烟患者(EH+SM) ,和 19例正常血压无吸烟史者 (NT)的血管内皮依赖性舒张功能进行测定评价 ,并测定其血浆一氧化氮 (NO) ,内皮素 (ET) ,血栓素 B2 (TXB2 )和前列腺环素 (PGI2 )等血管活性物质的浓度变化。结果　发现 EH+SM和 EH组肱动脉血流介导的血管舒张百分率 FMD%均较 NT组明显减弱 (P均 <0 .0 0 1) ,EH+SM组又较EH组明显减弱 (P=0 .0 2 3) ,而三组对硝酸甘油的反应无显著性差异 (P均 >0 .0 5 )。 EH+SM及 EH组血浆 NO,PGI2 水平均较 NT组减低 (P均 <0 .0 1) ,EH+SM组又较 EH组明显降低 (P=0 .0 2 9)。结论　高血压患者存在血管内皮依赖性舒张功能受损 ,高血压伴吸烟患者 ,内皮功能损伤进一步加重 ,高频超声是评价血管内皮依赖性舒张功能的简单、无创、可靠的方法。

Studies on Vascular Endothelium-dependent Relaxation in Patients with Hypertension or Hypertension Smokers By High Resolution Ultrasound Image

Objective To assess the endothelium dependent relaxation in patients with hypertension or hypertension smokers with high resolution ultrasound.Methods With high resolution ultrasound,we measured endotheliu dependent relaxing function in 63 subjects 22 of whom with essential hypertension(EH),22 of whom with both hypertension and smoking(EH+SM),and the others of whom as normal control We measured the diameters of the superficial femoral and brachial arteries at rest,during reactive hyperaemia,re test and after sublingual glyceryl trinitrate to evlauate the endothelium independent dilatation The level of plasma NO,ET,PGI 2,and TXB 2 were determined Results There were significantly smaller flow mediated dilatation in the EH or EH+SM patients than that in normal persons (all P <0 001) There was also significantly smaller flow mediated dilatation in the EH+SM compared with that in the EH ( P =0 023) By contrast,dilatation due to GTN did not differ from that in the control The concentration of plasma NO and PGI 2 in the EH and EH+SM were lower than those in the normal control (all P <0 01) The concentration of plasma NO and PGI 2was also significantly lower in the EH+SM than those in the EH ( P =0 029) Conclusions Endothelium dependent dilation was impaired in patients with hypertension The digree of impaired was more serious in hypertension smokers High resolution ultrasound image can be successfully used in assessing endothelium dependent dilation It is really a simple,non invasive and reliable technique for endothelium dependent dilation evaluation