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目的观察高血压患者内皮脂肪酶(EL)的变化,并探讨其与肱动脉血流介导的内皮依赖性血管舒张功能(FMD)的关系。方法入选初诊原发性高血压(EH)患者(EH组,n=132)和血压正常的健康体检者(对照组,n=118)为受试者,测量两组研究对象的身高、体质量、血压,检测空腹血糖、总胆固醇、三酰甘油、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C),用酶联免疫吸附法检测血浆EL的水平,用超声技术检测FMD,分析EL与FMD的相关性。结果EH组血浆EL水平明显高于对照组[(468.3±50.7)比(235.0±24.9)μg/L,P<0.05],FMD显著低于对照组[(7.2±2.1)%比(12.3±2.4)%,P<0.05],而且,随着高血压分级的增加,EL水平逐步升高,但是FMD逐渐下降(趋势均P<0.05)。对EH组进行Pearson相关分析显示FMD与收缩压、舒张压、体质量指数(BMI)、空腹血糖、总胆固醇、三酰甘油、LDL-C和EL呈负相关,与HDL-C呈正相关(均P<0.05)。多元线性逐步回归显示,校正年龄、性别、血压、血脂、血糖等因素后,EL是FMD的影响因素(P<0.05)。结论高血压患者FMD受损可能与血浆内皮脂肪酶水平升高有关。
Objective To investigate the changes of endothelium lipase (EL) in hypertensive patients and to explore its relationship with brachial artery-mediated endothelium-dependent vasodilatation (FMD). Methods The subjects with newly diagnosed essential hypertension (EH) (n = 132) and normal subjects with normotensive blood pressure (n = 118) were enrolled in the study. The height, body mass , Blood pressure, fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were measured. The levels of plasma EL were detected by enzyme-linked immunosorbent assay Technical detection of FMD, analysis of EL and FMD correlation. Results The level of plasma EL in EH group was significantly higher than that in control group [(468.3 ± 50.7) vs (235.0 ± 24.9) μg / L, P <0.05] and FMD was significantly lower than that in control group [(7.2 ± 2.1)% vs )%, P <0.05]. Moreover, the level of EL increased gradually with the increase of the grade of hypertension, but the level of FMD decreased gradually (all P <0.05). Pearson correlation analysis of EH group showed that FMD was negatively correlated with systolic blood pressure, diastolic blood pressure, body mass index (BMI), fasting blood glucose, total cholesterol, triglyceride, LDL-C and EL, P <0.05). Multivariate linear stepwise regression showed that EL was the influential factor of FMD (P <0.05) after adjusting for age, gender, blood pressure, blood lipids, blood glucose and other factors. Conclusions The impaired FMD in hypertensive patients may be related to the increase of plasma lipoprotein level.