摘要
目的:通过观察高血压昼夜节律消失、血管内皮功能及血液流变学改变以了解三者之间关系。方法:选择行24h动态血压监测的Ⅰ-Ⅱ级原发性高血压患者175例,男96例,女79例。根据夜间平均动脉压下降10%以上或以下的标准,将原发性高血压患者分为杓型组(107例)和非杓型组(68例)。分别采用高分辨率彩色血管超声,以肱动脉反应性充血前、后血管内径变化检测血管内皮依赖性扩张功能并行血液流变学各指标的测定。结果:①非杓型组的肱动脉反应性充血血管内径变化显著小于杓型组[(8·7±2·1)%∶(5·1±1·7)%,P<0·01);②非杓型组的凝血因子Ⅰ(Fg)、红细胞压积、全血黏度值、血浆黏度值、全血低切还原黏度、红细胞聚集指数显著高于杓型组(P<0·01,P<0·05);③通过建立Logistic回归方程,显示自变量(Fg、反应性充血血管内径变化)对因变量(血压昼夜节律)的回归系数为-4·094,+0·949,对因变量的OR值为0·017,2·583。结论:高血压昼夜节律消失、血管内皮功能受损、血液流变学异常呈正相关,三者之间相互作用,形成恶性循环。
Objective：To investigate the relationship between loss of diurnal rhythm of blood pressure, endothelial dysfunction and hemorrheology in essential hypertension （EH）. Method： According to ambulatory blood pressure, 175 patients（ 96 male , 79 female）with EH （stage Ⅰ and Ⅱ ）were divided into two groups, dipper（ n = 107）and non dipper （ n =68）. The caliber brachial artery was measured at rest, during increased flow and after sublingual nitroglycerin to evaluate endothelial function by using high resolution vascular ultrasound. And hemor rheologic indexes were measured. Result： ①The brachial arterial diameter change response to reactive hypermia was significantly lower in non dipper group than that in dipper group（8.7± 2. 1 vs 5.1 ± 1.7, P 〈0.01 ）. @The fibrinogen（Fg）, Hot, ηb, ηp, ηre, erythrocyte agglutination index（EAI） were significantly higher in non dipper group than that in dipper group（ P 〈0.05 , P 〈0.01 ）. ②In this study, Fg, the brachial arterial diameter ehange response to reactive hypermia is associated with diurnal rhythm of blood pressure in EH subject（regression coefficient： b = -4. 094,0. 949, OR =0. 017, 2. 583）. Conclusion：The loss of diurnal rhythm is closely correlated with vessel endothelial dysfunction and abnormal hemorrheology which affect each other and form a vicious circle in EH.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2005年第11期645-647,共3页
Journal of Clinical Cardiology
关键词
高血压
昼夜节律
内皮
血管
血液流变学
Hypertension
Diurnal rhythym
Endothelium,vascular
Hemorrheology
