早期原发性高血压患者血管内皮功能与颈动脉弹性功能、颈动脉内-中膜厚度的相关性研究

目的:研究早期原发性高血压患者血管内皮功能与颈动脉弹性功能、颈动脉内-中膜厚度(IMT)的相关性。方法:选取2017年4月至2018年5月福建医科大学附属宁德市医院收治的早期原发性高血压患者80例为研究对象,记为研究组,另选取同期于我院进行体检的健康志愿者69例记为对照组,采用彩色超声诊断仪分别检测并比较两组受试者血管内皮功能、颈动脉弹性功能和IMT,并采用Pearson相关性分析早期原发性高血压患者血管内皮功能与颈动脉弹性功能参数和颈动脉IMT的相关性。结果:与对照组比较,研究组基础内径明显增厚,内皮依赖性血管扩张值(FMD)明显降低(P0.05),而两组内皮非依赖性血管扩张值(NMD)比较差异无统计学意义(P0.05)。与对照组比较,研究组顺应性(AC)均明显降低,而硬度指数、压力应变弹性系数(Ep)、IMT明显升高,差异有统计学意义(P0.05)。经Pearson相关性分析显示,早期原发性高血压患者FMD与AC呈正相关,与硬度指数、Ep、IMT呈负相关(P0.05),而NMD与硬度指数、Ep、AC、IMT无相关性(P0.05)。结论:早期原发性高血压患者血管内皮功能明显受损、颈动脉弹性功能下降、IMT增厚,同时,患者血管内皮功能受损与颈动脉弹性功能下降、IMT增厚密切相关。

Early Essential Hypertension: Correlation between Vascular Endothelial Function and Carotid Artery Elasticity,Carotid Artery Intima-media Thickness

ABSTRACT Objective: To study the correlation between vascular endothelial function and carotid artery elasticity function and carotid artery intima-media thickness (IMT) in patients with early essential hypertension. Methods: A total of 80 patients with early essential hypertension, who were treated in Affiliated Ningde Hospital of Fujian Medical University from April 2017 to May 2018, were chosen as study group. Another 69 healthy persons, who received physical examination in Affiliated Ningde Hospital during the same period, were chosen as control group. The vascular endothelial function, carotid artery elasticity function and IMT were detected by color ultrasound diagnostic apparatus and were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between vascular endothelial function and carotid artery elasticity function parameters and IMT in the patients with early essential hypertension. Results: Compared with the control group, the basal diameter of the study group was significantly thickened,and flow-mediated dilation (FMD) was significantly decreased (P<0.05). There was no significant difference in nitroglycerin-mediated dilation (NMD) between the two groups (P>0.05). Compared with the control group, the arterial compliance (AC) of the study group was significantly decreased, while the hardness index, the pressure strain elasticity coefficient (Ep) and IMT were significantly increased, and the difference was statistically significant (P<0.05). Pearson correlation analysis showed that FMD was positively correlated with AC in the patients with early hypertension and was negatively correlated with hardness index, Ep and IMT (P<0.05). There was no correlation between NMD and hardness index, Ep, AC, IMT (P>0.05). Conclusion: Vascular endothelial function is significantly impaired in the patients with early essential hypertension, and carotid artery elasticity function is decreased, IMT is more thickening. At the same time, impaired vascular endothelial function is associated with decreased carotid artery elasticity function and IMT thickening.