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合并或未合并代谢综合征的高血压患者的内皮功能障碍与靶器官损害

[Endothelial dysfunction and target organ damage in hypertensive patients complicating with or without metabolic syndrome].

作者信息

Lin Jin-xiu, Yang Xia, Zheng Xiao-yong, Chen Da-guang

机构信息

Department of Cardiology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2007 Aug;35(8):710-4.

Abstract

OBJECTIVE

To investigate the impacts of metabolic syndrome (MS) on endothelial function and target organ damage in hypertensive patients.

METHODS

Patients with essential hypertension (EH) were divided into two groups: hypertension and metabolic syndrome (EH + MS, n = 61), hypertension without metabolic syndrome (EH + nonMS, n = 95) and 31 healthy subjects served as normal control (NC). The change of brachial artery vascular diameter, blood flow volume and vascular resistance after reactive hyperemia were measured by color Doppler ultrasonography.

RESULTS

(1) Triglyceride (TG), fasting blood glucose (FBG), body mass index (BMI) were higher in EH + MS group than that in EH + nonMS group (P < 0.05). (2) Endothelium-dependent Dilatation (FMD%) and rate of flow volume of reactive hyperemia were significantly lower in EH + MS group than that in EH + nonMS and NC group [(7.08 +/- 3.21)% vs. (8.18 +/- 1.74)% and (10.41 +/- 4.52)%, P < 0.05 and 0.01 respectively; (154.19 +/- 78.94)% vs. (196.44 +/- 64.22)% and (221.81 +/- 89.64)%, P < 0.05 and 0.01 respectively], while these parameters were similar between EH + nonMS and NC groups (P > 0.05). (3) The high sequence of forearm dilatation capability was also significantly reduced in EH + MS group compared to other groups. (4) The incidences of carotid atherosclerotic plaque and left ventricular hypertrophy (LVH) were significantly increased in EH + MS group compared to EH + nonMS group and NC group. (5) FMD was correlated with age, gender, smoking, SBP, DBP, TG, Fib respectively (P < 0.05). Intima-media thickness (IMT) of carotid artery was positively related with age, smoking, SBP, DBP, BMI, TG, Fib respectively. The left ventricular mass index (LVMI) was positively related with age, smoking, SBP, DBP, BMI, TG respectively. FMD was negatively related with IMT and LVMI respectively (P < 0.01).

CONCLUSION

Metabolic syndrome further aggravated endothelial dysfunction and target organ damage in patients with essential hypertension.

摘要

目的

探讨代谢综合征(MS)对高血压患者内皮功能和靶器官损害的影响。

方法

将原发性高血压(EH)患者分为两组:高血压合并代谢综合征(EH+MS,n=61)、高血压不合并代谢综合征(EH+nonMS,n=95),并选取31例健康受试者作为正常对照(NC)。采用彩色多普勒超声测量反应性充血后肱动脉血管内径、血流量及血管阻力的变化。

结果

(1)EH+MS组甘油三酯(TG)、空腹血糖(FBG)、体重指数(BMI)高于EH+nonMS组(P<0.05)。(2)EH+MS组内皮依赖性舒张功能(FMD%)及反应性充血血流量增加率显著低于EH+nonMS组和NC组[(7.08±3.21)%对(8.18±1.74)%和(10.41±4.52)%,P分别<0.05和0.01;(154.19±78.94)%对(196.44±64.22)%和(221.81±89.64)%,P分别<0.05和0.01],而EH+nonMS组与NC组这些参数相似(P>0.05)。(3)EH+MS组前臂扩张能力的高序列也较其他组显著降低。(4)EH+MS组颈动脉粥样硬化斑块和左心室肥厚(LVH)的发生率较EH+nonMS组和NC组显著增加。(5)FMD分别与年龄、性别、吸烟、收缩压(SBP)、舒张压(DBP)、TG、纤维蛋白原(Fib)相关(P<0.05)。颈动脉内膜中层厚度(IMT)分别与年龄、吸烟、SBP、DBP、BMI、TG、Fib呈正相关。左心室质量指数(LVMI)分别与年龄、吸烟、SBP

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