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原发性高血压患者静脉扩张性降低:缺乏全身血流动力学相关性。

Decreased venous distensibility in essential hypertension: lack of systemic hemodynamic correlates.

作者信息

Simon G, Franciosa J A, Cohn J N

出版信息

Angiology. 1979 Mar;30(3):147-59. doi: 10.1177/000331977903000301.

Abstract

Venous distensibility in essential hypertension has been reported to be unchanged or decreased; its pathophysiologic role is uncertain. In 27 male hypertensive patients and 21 normotensive control subjects, forearm venous distensibility and capillary filtration rate at 30 cm of H2O distending pressure were measured by strain gauge plethysmography. Plasma renin activity (PRA), plasma volume (PV) by the Evans blue dye dilution technique, mean arterial pressure (MAP) by cuff, and cardiac output (CO) by the CO2 rebreathing method were also measured. Compared to values in normotensive control subjects, forearm venous distensibility in hypertensive subjects was decreased (P less than 0.05); the forearm venous pressure-volume curves (deflation phase) were shifted in the direction of the pressure axis (P less than 0.02); and the capillary filtration rate was increased (P less than 0.05). Venous distensibility changes in hypertensive subjects were unrelated to PRA, MAP, PV, CO, stroke volume, and total peripheral resistance. These findings confirm previous reports of decreased venous distensibility in hypertension and provide direct evidence for increased capillary filtration rate. In view of the lack of significant correlation between venous distensibility and the measured hemodynamic parameters, a patho-physiologic role for venous distensibility in hypertension could not be established.

摘要

据报道,原发性高血压患者的静脉扩张性未发生改变或有所降低,其病理生理作用尚不确定。对27名男性高血压患者和21名血压正常的对照者,采用应变计体积描记法测量了在30 cm水柱扩张压下的前臂静脉扩张性和毛细血管滤过率。还测量了血浆肾素活性(PRA)、采用伊文思蓝染料稀释技术测定的血浆容量(PV)、用袖带测量的平均动脉压(MAP)以及采用二氧化碳重呼吸法测量的心输出量(CO)。与血压正常的对照者相比,高血压患者的前臂静脉扩张性降低(P<0.05);前臂静脉压力-容量曲线(放气期)向压力轴方向偏移(P<0.02);毛细血管滤过率升高(P<0.05)。高血压患者的静脉扩张性变化与PRA、MAP、PV、CO、每搏输出量和总外周阻力无关。这些发现证实了先前关于高血压患者静脉扩张性降低的报道,并为毛细血管滤过率升高提供了直接证据。鉴于静脉扩张性与所测量的血流动力学参数之间缺乏显著相关性,无法确定静脉扩张性在高血压中的病理生理作用。

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