CAJ | 학술논문

目的探讨血浆内皮素、血管紧张素(Ang)Ⅱ水平对高血压患者大脑中动脉阻力的影响.方法检测高血压1级(1级组,40例)、2级(2级组,40例)、3级(3级组,40例)以及健康体检者(对照组,50例)血浆内皮素和AngⅡ水平,采用经颅多普勒测定大脑中动脉收缩期流速和搏动指数,并进行24 h动态血压监测.结果 2、3级组搏动指数明显高于对照组和1级组(1.23±0.22、1.31±0.21比0.76±0.18、0.78±0.13)(P＜0.05).2级组收缩期流速明显高于对照组和1、3级组[(87.8±11.7) cm/s比(60.8±10.6)、(63.8±11.8)、(49.9±10.8) cm/s](P＜ 0.05),3级组明显低于对照组和1、2级组(P＜0.05).1、2、3级组血浆内皮素和AngⅡ均高于对照组[(46.83±8.83)、(55.63±10.28)、(67.19±10.73) ng/L比(38.94±7.83) ng/L和(50.23±9.23)、(64.34±12.23)、(79.83±13.43)ng/L比(41.63±8.76) ng/L](P＜ 0.05),1、2、3级组随高血压级别的增高血浆内皮素和AngⅡ明显增高(P＜0.05).60例杓型患者夜间平均收缩压、夜间平均舒张压和血浆内皮素、AngⅡ均明显低于60例非杓型患者[(121.83±11.83) mm Hg(1 mm Hg=0.133 kPa)比(138.84±13.29) mm Hg、(77.23±8.54) mm Hg比(86.93士10.34)mm Hg、(48.83±10.14) ng/L比(59.83±11.29) ng/L、(55.84±10,83)ng/L比(72.83±20.29) ng/L,P＜0.05].结论对高血压患者进行血浆内皮素、AngⅡ水平的检测以及动态血压的监测,在对患者进行治疗中改善内皮功能,并促进动态血压类型转变成为杓型,可降低高血压不良事件的发生率.
목적 탐토혈장내피소、혈관긴장소(Ang)Ⅱ수평대고혈압환자대뇌중동맥조력적영향.방법 검측고혈압1급(1급조,40례)、2급(2급조,40례)、3급(3급조,40례)이급건강체검자(대조조,50례)혈장내피소화AngⅡ수평,채용경로다보륵측정대뇌중동맥수축기류속화박동지수,병진행24 h동태혈압감측.결과 2、3급조박동지수명현고우대조조화1급조(1.23±0.22、1.31±0.21비0.76±0.18、0.78±0.13)(P＜0.05).2급조수축기류속명현고우대조조화1、3급조[(87.8±11.7) cm/s비(60.8±10.6)、(63.8±11.8)、(49.9±10.8) cm/s](P＜ 0.05),3급조명현저우대조조화1、2급조(P＜0.05).1、2、3급조혈장내피소화AngⅡ균고우대조조[(46.83±8.83)、(55.63±10.28)、(67.19±10.73) ng/L비(38.94±7.83) ng/L화(50.23±9.23)、(64.34±12.23)、(79.83±13.43)ng/L비(41.63±8.76) ng/L](P＜ 0.05),1、2、3급조수고혈압급별적증고혈장내피소화AngⅡ명현증고(P＜0.05).60례표형환자야간평균수축압、야간평균서장압화혈장내피소、AngⅡ균명현저우60례비표형환자[(121.83±11.83) mm Hg(1 mm Hg=0.133 kPa)비(138.84±13.29) mm Hg、(77.23±8.54) mm Hg비(86.93사10.34)mm Hg、(48.83±10.14) ng/L비(59.83±11.29) ng/L、(55.84±10,83)ng/L비(72.83±20.29) ng/L,P＜0.05].결론 대고혈압환자진행혈장내피소、AngⅡ수평적검측이급동태혈압적감측,재대환자진행치료중개선내피공능,병촉진동태혈압류형전변성위표형,가강저고혈압불량사건적발생솔.
Objective To investigate the plasma endothelin(ET),angiotensin (Ang) Ⅱ levels on middle cerebral artery resistance in hypertension patients.Methods The plasma ET and Ang Ⅱ levels were determined in hypertension grade 1 (grade 1 group,40 cases),grade 2 (grade 2 group,40 cases ),grade 3(grade 3 group,40 cases) and healthy adults (control group,50 cases).The systolic velocity and pulsatility index of middle cerebral artery were determined by transcranial Doppler,and 24 h ambulatory blood pressure was monitored.Results The pulsatility index in grade 2 group and grade 3 group was higher than that in control group and grade 1 group (1.23 ±0.22,1.31 ±0.21 vs.0.76 ±0.18,0.78 +0.13)(P＜0.05).The systolic velocity in grade 2 group was higher than that in control group,grade 1 group and grade 3 group [(87.8 ± 11.7) cm/s vs.(60.8 ± 10.6),(63.8 ± 11.8),(49.9 ± 10.8) cm/s](P ＜ 0.05),and in grade 3 group was lower than that in control group,grade 1 group and grade 2 group(P ＜ 0.05 ).The plasma ET,Ang Ⅱ in grade 1,2,3 group was higher than that in control group[(46.83 ± 8.83 ),(55.63 ± 10.28 ),(67.19 ± 10.73)ng/L vs.( 38.94 ± 7.83 ) ng/L and ( 50.23 ± 9.23 ),(64.34 ± 12.23 ),( 79.83 ± 13.43 ) ng/L vs.(41.63 ± 8.76 )ng/L] (P ＜0.05).A increasing trend in the plasma ET and Ang Ⅱ was present with increasing the hypertension grade (P ＜ 0.05 ).The night average systolic pressure,night average diastolic pressure and plasma ET,Ang Ⅱ levels in dipper hypertension patients (60 cases) were lower than those in non-dipper hypertension patients(60 cases) [(121.83 ± 11.83) mm Hg(1 mm Hg =0.133 kPa) vs.(138.84 ± 13.29)mm Hg,(77.23 ± 8.54) mm Hg vs.(86.93 ± 10.34) mm Hg,(48.83 ± 10.14) ng/L vs.(59.83 ± 11.29)ng/L,(55.84 ± 10.83 ) ng/L vs.(72.83 ± 20.29) ng/L,P ＜ 0.05].Conclusion Monitoring plasma ET,Ang Ⅱ levels and ambulatory blood pressure in hypertension patients is helpful in using medicine to improve endothelial function and to promote its dynamic type into a dipper blood pressure in the treatment of patients,thereby to reduce the incidence of hypertension adverse events.