糖脂代谢对原发性高血压病人血管内皮功能的影响

摘要

目的 探讨糖脂代谢对原发性高血压病人血管内皮功能的影响.方法 连续入选2016年01月至2016年12月于首都医科大学宣武医院心脏科门诊初次诊断为原发性高血压病人111例,所有病人均检测血液生物化学指标及血管内皮功能测试以得到血糖、血脂及反应性充血指数(reactive hyperemia index,RHI).依据RHI值分为RHI正常组(63例,RHI＞ 1.67)及RHI减低组(48例,RHI＜ 1.67).应用相关分析和多元线性回归分析血糖血脂与原发性高血压病人RHI的相关性.结果 RHI减低组在收缩压(systolic blood pressure,SBP)、空腹血糖(glucose,GLU)、糖化血红蛋白(glycosylated hemoglobin,HbAlc)、低密度脂蛋白(low density lipoprotein-cholesterol,LDL-C)等方面均高于RHI正常组,差异有统计学意义(P＜0.05).Pearson相关分析显示,SBP、GLU、HbA1c和LDL-C均与RHI呈负相关(P＜0.05).多元线性回归分析结果显示:SBP、LDL-C和GLU是影响RHI的独立危险因素,均与RHI呈负相关.结论 高血糖和高血脂会加重原发性高血压病人的血管内皮功能障碍.%Objective To investigate the effects of glucose and lipid metabolism on endothelial function in patients with essential hypertension.Methods A total of 111 patients with essential hypertension were consecutively enrolled in this study from January 2016 to December 2016 in Xuanwu Hospital.All the patients were tested for biochemical indexes and vascular endothelial function tests to get blood glucose,blood lipid and reactive hyperemia index.According to the size of reactive hyperemia index (RHI) is divided into RHI normal group (n =63,RHI ＞ 1.67) and low RHI group (n =48,RHI ＜ 1.67).Application of correlation analysis and multiple linear regression to analyze the correlation between blood glucose and blood lipid and RHI in patients with essential hypertension.Results The levels of age,gender,smoking rate and other indicators were no statistical difference in the two groups (P ＞ 0.05).The levels of systolic blood pressure (SBP),glucose (GLU),glycosylated hemoglobin (HbAlc),low density lipoprotein-cholesterol (LDL-C) in low RHI group were significantly higher than those in normal RHI group (P ＜0.05).Pearson correlation analysis showed that RHI was negatively correlated with SBP,GLU,HbAlc and LDL-C (P ＜ 0.05).Multivariate linear regression analysis showed that RHI was negatively correlated with SBP,GLU and LDL-C.Conclusion Hyperglycemia and hyperlipidemia increase the vascular endothelial dysfunction in patients with essential hypertension.