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关键词：高血压；内皮，血管/超声检查；内皮细胞舒血管因子
摘要 目的 探讨老年高血压患者内皮依赖性血管舒张功能的改变。 方法 应用无创伤性高分辨力超声检测77例老年高血压患者和20例正常血压者肱动脉对血流增加和硝酸甘油(NTG)的反应性，以肱动脉内径变化率表示血流和NTG介导的扩张，以评价血管内皮和平滑肌功能。 结果 与对照者比较，高血压Ⅰ期患者肱动脉血流介导性扩张的差异无显著性(两组分别为12.0%±1.7%及11.7%±2.3%，P>0.05)，高血压Ⅱ期和并发缺血性脑卒中患者肱动脉血流介导性扩张下降(分别为9.9%±1.7%和8.1%±2.5%，P<0.05)，尤以并发脑卒中组下降更明显，高血压Ⅱ期与并发脑卒中组之间的差异亦有显著性(P<0.05)；NTG介导的扩张在各组差异无显著性。 结论 老年高血压患者随病程进展血管内皮功能受损并逐渐加重，合并缺血性脑卒中者尤为明显，提示内皮功能不全对缺血性脑血管病的发生可能起着重要作用。
Non-invasivedetection of endothelium-dependent vascular relaxing function in the aged hypertensivepatients
Zhang Li, Liu Jinyao,Guo Huachao. Geriatric Division, Air Force General Hospital of PLA, Beijing 100036
Abstract Objective Tostudy non-invasively changes of endothelial function in elderly with hypertension. Methods Byusing high resolution ultrasonography vascular reactivity of 77 cases with hypertension(phase Ⅰ, phase Ⅱ and complicated with ischemic stroke) was studied. The caliber ofbrachial artery was measured at rest, during increased flow and after sublingualnitroglycerin (NTG) to evaluate endothelial and smooth muscle function. Results The flow-dependent dilatation (FDD) of brachialartery had no difference between the control and phase Ⅰ hypertension (12.0%±1.7% vs11.7%±2.3%) (P>0.05), but FDD in the phase Ⅱ hypertension and ischemic strokepatients was significantly reduced (P<0.05), especially in the ischemic stroke. Therewas no significant difference in NTG-induced dilatation. Conclusions Withthe progression of hypertension, endothelial function was impaired in the agedhypertensive patients, and more severely in the patients with ischemic stroke. The resultssuggest that endothelial dysfunction may play an important role in the development ofischemic cerebrovascular disease.
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