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采用Celermajer等的方法对照观察高血压(EH)患者在休息时、反应性充血 ,再休息以及含服硝酸甘油后肱动脉内径和血流的变化 ,以评价高血压患者血管内皮依赖性舒张功能的变化。方法采用高分辨超声技术 ,对51例EH患者和35例正常对照者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组肱动脉血流介导的血管舒张(FMD)较正常组明显减弱(5.70 %±1.6 %和10.2 %±2.7 % ,P<0.001) ,而两组对硝酸甘油的反应无显著性差异(19.8%±6.4 %和20.8 %±6.9 % ,P>0.05)。EH组血浆NO ,PGI2 水平较正常组低(分别为15.4±6.13 ,45.6±8.21与26.4±7.8,89.4±19.8。P<0.01)。结论EH患者存在血管内皮依赖性舒张功能受损 ,超声是评价血管内皮依赖性舒张功能的简便、无创、可靠的方法。
The Celermajer et al’s method was used to observe the changes of the brachial artery diameter and blood flow at rest, reactive hyperemia, rest, and nitroglycerin at rest to evaluate the endothelium-dependent vasodilatation in hypertensive patients Variety. Methods The endothelium-dependent vasodilation of 51 EH patients and 35 healthy controls were evaluated by high-resolution ultrasound. The levels of plasma nitric oxide (NO), endothelin (ET) thromboxane B2 (TXB2) ) And prostacyclin (PGI2) and other vasoactive substances. The results showed that the brachial artery-mediated vasodilation (FMD) in EH group was significantly weaker than that in the normal group (5.70% ± 1.6% and 10.2% ± 2.7%, P <0.001), while the response to nitroglycerin in both groups was not significant (19.8% ± 6.4% and 20.8% ± 6.9%, P> 0.05). Plasma NO and PGI2 levels in EH group were lower than those in normal group (15.4 ± 6.13, 45.6 ± 8.21 and 26.4 ± 7.8, 89.4 ± 19.8, P <0.01, respectively). Conclusion EH patients have impaired endothelium-dependent vasodilatation. Ultrasound is a simple, noninvasive and reliable method for evaluating endothelium-dependent vasodilation.