摘要
目的以胫前动脉为靶点,检测原发性高血压(EH)患者的内皮依赖性舒张(EDD)和非内皮依赖性舒张功能(EID),分析左心室肥厚(LVH)与血管舒张功能的关系及影响因素。方法入选门诊EH患者307例,选择同期在门诊初诊的正常血压者39例作为对照组。所有受试者在入选前测量身高、体质量、心率和血压,测定血生化指标,检查超声心动图,并计算左心室质量指数(LVMI)。采用高分辨率血管彩色超声技术,测定反应性充血前后靶动脉内径的变化率{[加压后内径(D1)-胫前动脉的基础内径(D0)]/D0×100%}为EDD;含服硝酸甘油前后靶动脉内径的变化率{[(含服硝酸甘油后的内径(D2)-D0]/D0×100%}为EID。根据LVH的诊断标准[LVMI≥125(男)或≥110g/m2(女)]将EH患者分为非LVH(NLVH,n=217)和LVH(n=90)组。结果 LVH组EDD[(6.99±6.62)%比(8.76±6.69)%、(10.96±7.25)%]和EID[(12.51±9.44)%比(17.19±11.92)%、(18.87±9.09)%]明显低于NLVH和对照组(均P<0.05)。多元逐步回归分析显示,EDD与EID互相影响;LVM、基础内径和高血压病程是EID的影响因素;EID、心率和高血压病程是LVMI的影响因素。结论 EH合并LVH患者的胫前动脉舒张功能明显降低。LVMI与血管舒张功能相关,EDD与EID互相影响。
Objective To investigate the relationship between left ventricular hypertrophy （LVH） and the vasodila- tation of anterior tibial artery and related factors. Methods A total of 307 outpatients with essential hypertension （EH） were enrolled, and 39 normotensive outpatients served as controls. Before the enrollment, body height and weight, heart rate and blood pressure were recorded for all the patients. Plasma biochemical indexes were deter- mined, eehocardiographie examination was conducted, and left ventricular mass index （LVMI） was calculated. The dilatation of anterior tibial artery induced by reactive hyperemia and nitroglycerin was examined by high-resolution vascular ultrasound, and was then defined as endothelium-dependent dilatation{[the diameter under the pressure （ D1 ）-baseline diameter（ D0 ） ]/Do 100 % （EDD） } and endothelium-independent dilatation [- （ the diameter after taking nitroglycerin（Dz ）--D0-[/D0 X 100% （EID）}. According to the diagnostic criteria of LVH （LVMI^125 g/mz for males or LVMI110 g/m2 for females}, the EH patients were divided into non-LVH group （n= 217） and LVH group （n=90）. Results Thelevels of EDD[（6.99±6.62}% vs （8.76±6.69）%, （10.96±7.25）%] and EID [（12.51±9.44}% vs （17.19 ±11.92）%, （18.87±9.09）%] were much lower in LVH group than those in non- LVH group and control group （all P〈0.05）. Multivariable stepwise regression analysis indicated that EDD and EID interacted with each other, and left ventricular mass { LVM）, baseline diameter of the target artery, and hyper- tension duration had an influence on EID, while EID, heart rate and hypertension duration had an influence on LVMI. Conclusion The Vasodilatation of anterior tibial artery in EH patients with LVH is obviously reduced than in those without LVH. There is a close relation between LVMI and vasodilatation, as well as between EDD and EID.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2014年第4期365-370,共6页
Chinese Journal of Hypertension
基金
福建医科大学临床医学重点学科(高血压学)经费资助(XK201107)
关键词
原发性高血压
左心室肥厚
内皮依赖性舒张功能
非内皮依赖性舒张功能
Essential hypertension
Left ventricular hypertrophy
Endothelium-dependent dilatation
Endothelium-independent dilatation
