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在高血压患者中,内皮功能障碍和随后的膜过率下降

Francesco Perticone¹, Raffaele Maio, Maria Perticone

¹Full Professor of Internal Medicine, Department of Medicina Sperimentale e Clinica, Campus Universitario Salvatore Venuta di Germaneto, Viale Europa, Catanzaro, Italy. perticone@unicz.it

|July 14, 2010

概括

内皮功能障碍,以降低乙胆刺激的血管扩张为标志,与高血压患者估计的膜过率 (eGFR) 降低的速度更快有关. 这突显了内皮功能作为慢性病进展的关键因素.

科学领域:

腎臟病學 (nephrology) 是一種醫學專業.
心血管医学心血管医学
高血压研究高血压研究

背景情况:

慢性病 (CKD) 是心血管疾病和死亡的一个重要风险因素.
内皮功能障碍可能在功能衰竭的早期发生,但其在CKD进展中的作用尚不清楚.
这项研究前性地研究了内皮功能对基本高血压中估计的膜过率 (eGFR) 降低的影响.

研究的目的:

评估内皮功能与从未接受过治疗的高血压患者的EGFR下降率之间的关联.
为了确定内皮功能是否预测基本高血压的功能恶化.
为了确定影响eGFR变化的心血管风险因素.

主要方法:

纳入了500名未经治疗的高血压患者,血清肌素≤1.5 mg/dL.
用压力测量 Plethysmography 评估内皮功能,使用乙胆和酸.
使用CKD-EPI方程计算eGFR,并在92.3个月的平均随访期内确定年度下降率 (DeltaeGFR/y).

主要成果:

平均每年的eGFR下降为1.49mL·min-1·1.73m-2.2.
乙胆刺激的前臂血流与DeltaeGFR/y (r=-0.256,P<0.0001) 呈现出显著的逆相关性.
多变量分析证实,前臂血流和缩血压与eGFR变化独立相关.

结论:

乙胆刺激的血管扩张障碍和较高的静脉血压与基本高血压中加速的eGFR损失有关.
内皮功能是高血压患者功能下降的重要预测因素.
这些发现强调了内皮健康在管理高血压病中的重要性.

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