Barenbrock M, Hausberg M, Kosch M, Kisters K, Hoeks A P, Rahn K H
Department of Medicine D, University of Münster, Germany.
J Hum Hypertens. 1998 Oct;12(10):707-11. doi: 10.1038/sj.jhh.1000692.
The mechanisms responsible for reduced arterial distensibility in renal transplant recipients remain to be evaluated. The present longitudinal study was aimed to evaluate the effect of hypertension on the evolution of vessel wall properties in renal transplant recipients. The mechanical properties of the common carotid artery were determined in 24 normotensive and 24 treated hypertensive renal transplant recipients 6-12 weeks after transplantation. The measurements were repeated after 2 years. Arterial distension was determined by using a multigate pulsed Doppler system, blood pressure (BP) was measured by a mercury sphygmomanometer. BP was 127 +/- 3/80 +/- 2 mm Hg at entry and 133 +/- 3/82 +/- 2 mm Hg after 2 years in the normotensive group, 146 +/- 4/90 +/- 3 mm Hg at entry and 145 +/- 3/87 +/- 2 mm Hg after 2 years in the hypertensive group (P < 0.01, normotensives vs hypertensives). The distensibility coefficient (DC) decreased significantly after 2 years in the hypertensive group (DC 18.3 +/- 1.3 10(-3)/kPa before, 15.1 +/- 1.2 10(-3)/kPa after 2 years, P < 0.05) whereas no significant change was observed in the normotensive group (DC 19.0 +/- 1.4 10(-3)/kPa before, DC 17.8 +/- 1.3 10(-3)/kPa after 2 years, NS). There was a significant correlation between the change of the distensibility coefficient after 2 years and mean arterial pressure (n = 48, r = 0.42, P < 0.01). The results show that the decrease of arterial distensibility after 2 years is accelerated in hypertensive renal transplant recipients despite effective anti-hypertensive treatment. Since BP levels were not different at entry into the study and after 2 years, differences in distending pressure along cannot explain the more pronounced decrease of arterial distensibility over time in hypertensive renal transplant recipients.
肾移植受者动脉扩张性降低的机制仍有待评估。本纵向研究旨在评估高血压对肾移植受者血管壁特性演变的影响。在24名血压正常和24名接受治疗的高血压肾移植受者移植后6 - 12周测定颈总动脉的力学特性。2年后重复测量。使用多门脉冲多普勒系统测定动脉扩张，用汞柱血压计测量血压（BP）。血压正常组入组时BP为127±3/80±2 mmHg，2年后为133±3/82±2 mmHg；高血压组入组时BP为146±4/90±3 mmHg，2年后为145±3/87±2 mmHg（P<0.01，血压正常者与高血压者相比）。高血压组2年后扩张系数（DC）显著降低（DC之前为18.3±1.3×10⁻³/kPa，2年后为15.1±1.2×10⁻³/kPa，P<0.05），而血压正常组未观察到显著变化（DC之前为19.0±1.4×10⁻³/kPa，2年后为17.8±1.3×10⁻³/kPa，无显著性差异）。2年后扩张系数的变化与平均动脉压之间存在显著相关性（n = 48，r = 0.42，P<0.01）。结果表明，尽管进行了有效的抗高血压治疗，但高血压肾移植受者2年后动脉扩张性的降低仍加速。由于研究入组时和2年后的血压水平无差异，沿血管的扩张压力差异无法解释高血压肾移植受者动脉扩张性随时间更明显的降低。
