摘要
目的探讨血浆内皮素、血管紧张素（Ang）Ⅱ水平对高血压患者大脑中动脉阻力的影响。方法检测高血压1级（1级组，40例）、2级（2级组，40例）、3级（3级组，40例）以及健康体检者（对照组，50例）血浆内皮素和AngⅡ水平，采用经颅多普勒测定大脑中动脉收缩期流速和搏动指数，并进行24h动态血压监测。结果2、3级组搏动指数明显高于对照组和1级组（1．23±0．22、1．31±0．21比0．76±0．18、0．78±0．13）（P〈0．05）。2级组收缩期流速明显高于对照组和1、3级组[（87．8±11．7）em／s比（60．8±10．6）、（63．8±11．8）、（49．9±10．8）cm／s]（P〈0．05），3级组明显低于对照组和1、2级组（P〈0．05）。1、2、3级组血浆内皮素和AngII均高于对照组[（46．83±8．83）、（55．63±10．28）、（67．19±10．73）ng／L比（38．94±7．83）ng／L和（50．23±9．23）、（64．34±12．23）、（79．83±13．43）ng/L比（41．63±8．76）ng/L]（P〈0．05），1、2、3级组随高血压级别的增高血浆内皮素和AngⅡ明显增高（P〈0．05）。60例杓型患者夜间平均收缩压、夜间平均舒张压和血浆内皮素、AngⅡ均明显低于60例非杓型患者[（121．83±11．83）mmHg（1mm Hg=0．133kPa）比（138．84±13．29）mmHg、（77．23±8．54）mmHg比（86．93±10．34）mmHg、（48．83±10．14）ng／L比（59．83±11．29）ng／L、（55．84±10．83）ng／L比（72．83±20．29）ng／L，P〈0．05]。结论对高血压患者进行血浆内皮素、AngⅡ水平的检测以及动态血压的监测，在对患者进行治疗中改善内皮功能，并促进动态血压类型转变成为杓型，可降低高血压不良事件的发生率。
Objective To investigate the plasma endothelin （ET）, angiotensin （Ang） Ⅱ levels on middle cerebral artery resistance in hypertension patients. Methods The plasma ET and Ang Ⅱ levels were determined in hypertension grade 1 （grade 1 group,40 cases）, grade 2 （grade 2 group, 40 cases）, grade 3 （grade 3 group, 40 cases） and healthy adults （control group, 50 cases）. The systolic velocity and pulsatiiity index of middle cerebral artery were determined by transcranial Doppler, and 24 h ambulatory blood pressure was monitored. Results The pulsatility index in grade 2 group and grade 3 group was higher than that in control group and grade 1 group （1.23 ±0.22,1.31 ±0.21 vs. 0.76 ±0.18, 0.78 ±0.13）（P〈0.05）. The systolic velocity in grade 2 group was higher than that in control group, grade 1 group and grade 3 group [ （87.8 ± 11.7） cm/s vs. （60.8 ± 10.6）, （63.8 ± 11.8）, （49.9 ± 10.8） em/s]（P〈 0.05）,and in grade 3 group was lower than that in control group, grade 1 group and grade 2 group （P 〈 0.05 ）. The plasma ET, Ang I1 in grade 1,2,3 group was higher than that in control group [ （46.83 ± 8.83 ）, （55.63 ± 10.28 ）, （67.19 ± 10.73 ） ng/L vs. （ 38.94 -± 7.83 ） ng/L and （50.23 ± 9.23 ）, （64.34 ± 12.23 ）, （79.83 ± 13.43 ） ng/L vs. （41.63 ± 8.76） ng/L ] （P 〈0.05）. A increasing trend in the plasma ET and Ang lI was present with increasing the hypertension grade （P 〈 0.05 ）. The night average systolic pressure, night average diastolic pressure and plasma ET, Ang 11 levels in dipper hypertension patients （60 cases） were lower than those in non-dipper hypertension patients （ 60 cases ） [ （ 121.83 ± 11.83 ） mm Hg （ 1 mm Hg = 0.133 kPa） vs. （ 138.84 ± 13.29 ） mm Hg, （77.23 ± 8.54） mm Hg vs. （86.93 ± 10.34） mm Hg, （48.83 ± 10.14） ng/L vs. （59.83 ± 11.29） ng/L, （55.84 ± 10.83 ） ng/L vs. （72.83 ± 20.29） ng/L,P〈 0.05 ]. Conclusion Monitoring plasma ET,Ang 11 levels and ambulatory blood pressure in hypertension patients is helpful m using medicine to improve endothelial function and to promote its dynamic type into a dipper blood pressure in the treatment of patients, thereby to reduce the incidence of hypertension adverse events.
出处
《中国医师进修杂志》
2012年第25期9-12,共4页
Chinese Journal of Postgraduates of Medicine
关键词
高血压
血管紧张素Ⅱ
内皮素
动态血压
Hypertension
Angiotensin Ⅱ
Endothelin
Ambulatory blood pressure
