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目的探讨原发性高血压患者盐敏感性与血管重构的关系。方法选择原发性高血压患者204例(高血压组),高血压组又分为:盐敏感性组96例和盐不敏感性组108例,另选46例健康体检者作为对照组。采用ELISA法测定血清血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF),超声测试肱动脉血流介导的血管舒张功能(FMD)和颈动脉内膜中层厚度(IMT)。结果高血压组患者尿酸、体重指数较对照组明显升高(P<0.01)。与盐不敏感性组比较,盐敏感性组患者LDL-C、尿酸明显升高,HDL-C明显下降(P<0.01)。高血压组患者VEGF、bFGF、IMT较对照组明显升高,FMD明显下降(P<0.01)。盐敏感性组患者VEGF、bFGF、IMT较盐不敏感性组进一步升高,FMD进一步下降(P<0.01)。回归分析显示,盐敏感性、TC、TG、lgVEGF是IMT独立预测指标,盐敏感性与IMT独立相关(r=0.534,P<0.01)。结论盐敏感性是高血压患者血管重构、靶器官损害的独立预测因素。
Objective To investigate the relationship between salt sensitivity and vascular remodeling in patients with essential hypertension. Methods 204 patients with essential hypertension (hypertension group) were selected. Hypertension group was divided into salt sensitive group (96 cases) and salt - insensitive group (108 cases). Another 46 healthy subjects were selected as control group. Serum levels of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were measured by ELISA. Brachial artery-mediated vasodilation (FMD) and carotid artery intima-media thickness (IMT) were measured by ultrasound. Results The uric acid and body mass index of patients with hypertension were significantly higher than those of the control group (P <0.01). Compared with salt-insensitive group, LDL-C and uric acid were significantly increased and HDL-C significantly decreased in salt-sensitive group (P <0.01). The levels of VEGF, bFGF and IMT in hypertensive group were significantly higher than those in control group, and the FMD was significantly decreased (P <0.01). The levels of VEGF, bFGF and IMT in salt-sensitive group were higher than those in salt-sensitive group, and FMD was further decreased (P <0.01). Regression analysis showed that salt sensitivity, TC, TG and IgVEGF were independent predictors of IMT. Salt sensitivity was independently associated with IMT (r = 0.534, P <0.01). Conclusion Salt sensitivity is an independent predictor of vascular remodeling and target organ damage in hypertensive patients.