CAJ | 학술논문

目的探讨直立性高血压(OHT)儿童血浆中一氧化氮(NO)水平和一氧化氮合酶(NOS)活性的变化,及其与血压变化的关系.方法选择2012年6月至2013年6月在北京大学第一医院儿科门诊及病房确诊的51例OHT儿童为OHT组[年龄(12±2)岁],选择同期本院门诊行健康体检的28例儿童为健康对照组[年龄(12±1)岁].OHT的诊断基于临床表现及直立试验检查,血浆NO水平测定使用硝酸还原酶方法,血浆NOS活性使用化学比色法测定.结果 1.OHT组与健康对照组儿童在年龄、性别分布、身高、体质量及体质量指数(BMI)方面差异无统计学意义(P均＞0.05).2.OHT组儿童直立后收缩压和舒张压均明显高于平卧位血压,分别为:收缩压(114±10) mmHg(1 mmHg =0.133 kPa)和(104±9) mmHg(t=-12.853,P＜0.001),舒张压(73±7)mmHg和(59±8) mmHg(t=-21.859,P＜0.001).3.血浆NO水平在OHT组明显低于健康对照组[(28.947±6.031) μmol/L比(35.216±6.662)μmol/L,t=4.257,P＜0.001],血浆NOS活性在OHT组明显低于对照组[(14.753 ±3.060) U/mL比(17.560±4.253) U/mL,t =3.026,P=0.006].4.血浆NO水平与直立后收缩压和收缩压变化值呈负相关(r=-0.276、-0.280,P均＜0.05).结论 OHT儿童血浆NO水平及NOS活性明显降低,提示OHT儿童存在血管内皮功能损伤.
목적 탐토직립성고혈압(OHT)인동혈장중일양화담(NO)수평화일양화담합매(NOS)활성적변화,급기여혈압변화적관계.방법 선택2012년6월지2013년6월재북경대학제일의원인과문진급병방학진적51례OHT인동위OHT조[년령(12±2)세],선택동기본원문진행건강체검적28례인동위건강대조조[년령(12±1)세].OHT적진단기우림상표현급직립시험검사,혈장NO수평측정사용초산환원매방법,혈장NOS활성사용화학비색법측정.결과 1.OHT조여건강대조조인동재년령、성별분포、신고、체질량급체질량지수(BMI)방면차이무통계학의의(P균＞0.05).2.OHT조인동직립후수축압화서장압균명현고우평와위혈압,분별위:수축압(114±10) mmHg(1 mmHg =0.133 kPa)화(104±9) mmHg(t=-12.853,P＜0.001),서장압(73±7)mmHg화(59±8) mmHg(t=-21.859,P＜0.001).3.혈장NO수평재OHT조명현저우건강대조조[(28.947±6.031) μmol/L비(35.216±6.662)μmol/L,t=4.257,P＜0.001],혈장NOS활성재OHT조명현저우대조조[(14.753 ±3.060) U/mL비(17.560±4.253) U/mL,t =3.026,P=0.006].4.혈장NO수평여직립후수축압화수축압변화치정부상관(r=-0.276、-0.280,P균＜0.05).결론 OHT인동혈장NO수평급NOS활성명현강저,제시OHT인동존재혈관내피공능손상.
Objective To explore the changes in plasma nitric oxide (NO) and nitric oxide synthase (NOS) activity in children with orthostatic hypertension(OHT) and the relationship with blood pressure changes.Methods The OHT group included 51 children who were diagnosed OHT in in-patient and out-patient departments of Peking University First Hospital from Jun.2012 to Jun.2013.Their age range was (12 ± 2) years.At the same time,control group consisted of 28 normal children who received physical examination with their age range of(12 ± 1) years.The diagnosis of OHT was based on the clinical manifestation and head-up tests.Plasma NO was determined by using a nitrate reductase method and plasma NOS activity by a chemical colorimetric method.Results 1.There were no significant differences between OHT group and control group in age,sex ratio,height,weight and body mass index (all P ＞0.05).2.In OHT children,the upright systolic blood pressure was higher than that of the supine [(114 ± 10) mmHg vs (104 ± 9) mmHg,t =-12.853,P ＜ 0.001],and the upright diastolic blood pressure was higher than that of the supine[(73 ±7) mmHg vs(59 ± 8) mmHg,t =-21.859,P ＜0.001].3.Plasma NO level and NOS activity,however,were significantly lower in OHT group than those in the control group [NO:(28.947 ± 6.031) μmol/L vs (35.216 ±6.662) μmol/L,t =4.257,P ＜ 0.001 ; NOS activity:(14.753 ± 3.060) U/mL vs (17.560 ± 4.253) U/mL,t =3.026,P =0.006].4.There was significantly negative correlation between plasma NO and the upright systolic blood pressure(r =-0.276,P ＜ 0.05) and the systolic blood pressure change (r =-0.280,P ＜ 0.05).Conclusions Plasma NO level and NOS activity were significantly lower in OHT children than those in control group.The abnormal vascular endothelial function may play an important role in OHT in children.