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目的探讨原发性高血压患者盐敏感性与血管内皮功能障碍的关系。方法根据急性静脉盐水负荷和呋喃苯胺酸缩容试验将204例原发性高血压患者分为盐敏感性高血压(SS)(n=96)和盐不敏感性高血压(NSS)(n=108),46例正常人设为对照组。采用双抗体夹心固相免疫法测定血清血管性血友病因子(v WF)、放免法测定内皮素1水平,用超声诊断仪测定肱动脉血流介导的内皮依赖性血管舒张功能(FMD)。结果SS组vWF、内皮素1较NSS组高(P<0.05),FMD较NSS组为低(P<0.05)。相关分析显示SS组FMD与血清v WF、内皮素1水平呈负相关(r分别为-0.362,-0.431,均P<0.01),而NSS组FMD与v WF、内皮素1无相关(r分别为-0.146,-0.172,P>0.05)。多元线性回归分析显示,盐敏感性(β=-0.193)、v WF(β=-0.286)、内皮素1(β=-0.322)与FMD独立相关(均P<0.01)。结论盐敏感性会加重高血压患者血管内皮功能的损伤。
Objective To investigate the relationship between salt sensitivity and vascular endothelial dysfunction in patients with essential hypertension. Methods 204 patients with essential hypertension were divided into salt-sensitive hypertension (SS) (n = 96) and salt-sensitive hypertension (NSS) according to acute venous saline load and furosemide condensation test (n = 108), 46 normal subjects as control group. Serum von Willebrand factor (vWF) was measured by double antibody sandwich immunoassay. Endothelin-1 level was determined by radioimmunoassay. Brachial artery-mediated endothelium-dependent vasodilation (FMD) . Results The levels of vWF and ET in SS group were higher than those in NSS group (P <0.05). FMD was lower than that in NSS group (P <0.05). Correlation analysis showed that FMD in SS group was negatively correlated with vWF and ET-1 levels (r = -0.362 and -0.431, respectively, P <0.01), while there was no correlation between FMD and vWF and ET-1 -0.146, -0.172, P> 0.05). Multivariate linear regression analysis showed that salt sensitivity (β = -0.193), v WF (β = -0.286) and endothelin 1 (β = -0.322) were independently associated with FMD (all P <0.01). Conclusion Salt sensitivity may aggravate the vascular endothelial dysfunction in hypertensive patients.