高血压前期体检人群血管内皮功能及其与脉搏波传导速度的关系
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国家“十二五”科技支撑计划项目(2011BAI11B01);湖南省工程技术研究中心建设项目(2009TP4026)


Relationship Between Vascular Endothelial Function and Pulse Wave Velocity in Prehypertension
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    目的 探讨高血压前期体检人群血管内皮功能情况及与高血压和正常人群的差别,并分析其与动脉硬化的相关性。方法 随机选取810例年龄43.06±8.54岁的体检人群作为研究对象,分为三组:高血压组、高血压前期组、正常组。以臂踝脉搏波传导速度(baPWV)和肱动脉血流介导的舒张功能(FMD)作为评估动脉硬化和内皮功能的指标。结果 高血压前期组baPWV比高血压组低(1419.98±209.18 cm/s比1487.92±316.99 cm/s,P<0.001),FMD比高血压组高(6.84%±2.64%比6.45%±2.46%,P<0.001),与正常组相比差异有统计学意义(分别为1243.33±170.52 cm/s和8.01%±2.78%)。在全人群、高血压组和高血压前期组中FMD与baPWV存在负相关(r分别为-0.316、-0.354、-0.266,P<0.001),但在正常组中两者无明显相关性(r=-0.104,P=0.097)。在高血压前期组中对影响baPWV的因素进行多元线性逐步回归分析,FMD进入回归方程。结论 在高血压前期人群中,血管内皮功能障碍已经开始,因此在高血压前期人群中开展血管内皮功能的检测和干预可以避免动脉硬化的进展和恶化。

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    Aim To investigate the association between vascular endothelial function and arteriosclerosis in prehypertensive, hypertensive and healthy subjects. Methods 810 consecutive subjects were divided into three groups: hypertension group, prehypertension group and control group. Brachial-ankle pulse wave velocity (baPWV) and flow-mediated brachial artery dilation (FMD) were used to evaluate the artery vascular stiffness and endothelial function respectively. Results Prehypertension group had lower baPWV values and higher FMD values than those in hypertension group(1419.98±209.18 cm/s vs 1487.92±316.99 cm/s and 6.84%±2.64% vs 6.45%±2.46%, P<0.001). And there were significant differences between prehypertension group and normal group (1243.33±170.52 cm/s and 8.01%±2.78%). Furthermore, FMD was significantly and negatively correlated to baPWV in overall population (r-0.316,P<0.001), hypertension (r=-0.354, P<0.001) and prehypertension(r=-0.266, <0.001) group but not in normal group (r=-0.104, P=0.097). Stepwise multiple linear regression analysis showed that FMD was significantly correlated to baPWV in prehypertension group. Conclusions Vascular endothelial dysfunction is initiated in prehypetensive subjects. Therefore, it is necessary to detect FMD in prehypertensive subjects to avoid the progress of arteriosclerosis.

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杨娉婷,袁 洪,王雅琴,曹 霞,陈志恒.高血压前期体检人群血管内皮功能及其与脉搏波传导速度的关系[J].中国动脉硬化杂志,2014,22(5):472~476.

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  • 收稿日期:2013-10-22
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