低钠高钾饮食干预对高血压患者NO、ET-1水平及动脉僵硬度的影响
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摘要
目的探究低钠高钾饮食干预对高血压患者一氧化氮(nitric oxide, NO)、内皮素-1(endothelin-1, ET-1)水平及动脉僵硬度的影响。方法选取2016年10月～2017年10月我院收治的高血压患者98例,随机将研究对象分为对照组与研究组, 2组患者均进行常规降压治疗,其中对照组患者42例给予普通饮食,而研究组患者56例则给予低钠高钾饮食干预。在饮食干预一年后,观察比较2组患者在干预前后的血清NO、ET-1水平、血压情况以及动脉僵硬度。结果干预前, 2组患者的SBP、DBP、血清NO、ET-1水平、以及CAVI水平经比较差异均无统计学意义(P>0.05);干预后,研究组患者的SBP与DBP水平均较对照组更低(P<0.05),研究组患者的血清NO水平高于对照组, ET-1水平低于对照组(P<0.05),且研究组患者的CAVI水平也低于对照组(P<0.05),差异存在统计学意义。结论低钠高钾饮食干预可一定程度的改善高血压患者的血清NO、ET-1水平,降低血压,缓解动脉僵硬度,保护患者的血管内皮功能。
Objective To analyze the effects of low-sodium and high-potassium diet intervention on nitric oxide(NO), endothelin-1(ET-1) levels and arterial stiffness in hypertensive patients. Methods Totally 98 patients with hypertension admitted to our hospital from October 2016 to October 2017 were randomly divided into the control group and the study group. Both groups were treated with conventional antihypertensive therapy. Among them, 42 patients in the control group were given a normal diet, while 56 patients in the study group were given a low-sodium and high-potassium diet. One year after dietary intervention, serum NO, ET-1 levels, blood pressure, and arterial stiffness were compared between the 2 groups before and after intervention. Results There were no significant differences in SBP, DBP, serum NO, ET-1 levels, and CAVI levels between the 2 groups(P>0.05) before intervention.After intervention, the SBP and DBP levels, ET-1 levels, and CAVI levels in the study group were lower than those in the control group(P<0.05), and the serum NO level in the study group was higher than that in the control group(P<0.05), the differences were statistically significant. Conclusion The intervention of low-sodium and high-potassium diet can improve the levels of serum NO and et-1 in patients with hypertension to a certain extent,reduce blood pressure, relieve arterial stiffness, and protect the vascular endothelial function of patients.
Objective To analyze the effects of low-sodium and high-potassium diet intervention on nitric oxide(NO), endothelin-1(ET-1) levels and arterial stiffness in hypertensive patients. Methods Totally 98 patients with hypertension admitted to our hospital from October 2016 to October 2017 were randomly divided into the control group and the study group. Both groups were treated with conventional antihypertensive therapy. Among them, 42 patients in the control group were given a normal diet, while 56 patients in the study group were given a low-sodium and high-potassium diet. One year after dietary intervention, serum NO, ET-1 levels, blood pressure, and arterial stiffness were compared between the 2 groups before and after intervention. Results There were no significant differences in SBP, DBP, serum NO, ET-1 levels, and CAVI levels between the 2 groups(P>0.05) before intervention.After intervention, the SBP and DBP levels, ET-1 levels, and CAVI levels in the study group were lower than those in the control group(P<0.05), and the serum NO level in the study group was higher than that in the control group(P<0.05), the differences were statistically significant. Conclusion The intervention of low-sodium and high-potassium diet can improve the levels of serum NO and et-1 in patients with hypertension to a certain extent,reduce blood pressure, relieve arterial stiffness, and protect the vascular endothelial function of patients.
引文
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[7]王松,宋金萍,郭丽荣.高盐饮食对血压影响的研究进展[J].心肺血管病杂志, 2018, 37(2):169-171.WangS,SongJP,GuoLR.Researchprogressontheeffectofhighsalt dietonbloodpressure[J].JCardiovascPulmonDis,2018,37(2):169-171.
[8]李瑜,欧阳菊艳,范丽,等.高血压患者24 h尿钠钾比值对同型半胱氨酸水平的影响研究[J].中国全科医学, 2017, 20(22):2746-2750.Li Y, OuYang JY, Fan L, et al. Effect of 24h urinary sodium to potassium ratio on the level of homocysteine in patients with hypertension[J]. Chin Gener Pract, 2017, 20(22):2746-2750.
[9]段翔,边波,孙跃民.高血压患者盐摄入量对尿蛋白和左心室质量指数的影响[J].中国慢性病预防与控制, 2018, 26(5):334-337.Duan X, Bian B, Sun YM. Effects of salt intake on urinary protein and left ventricularmassindexinpatientswithhypertension[J].ChinJPrev Control Chronic Non-Commun Dis, 2018, 26(5):334-337.
[10]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志, 2011, 39(7):583-586.ChinaHypertensionPreventionandTreatmentGuidelinesRevision Committee.Guidelinesforpreventionandtreatmentofhypertensionin China 2010[J]. Chin J Cardiol, 2011, 39(7):583-586.
[11]田国祥,张灵,张薇,等.糖尿病患者心跺血管指数与颈动脉硬化的相关性及其危险因素分析[J].中国综合临床, 2012, 28(1):28-31.Tian GX, Zhang L, Zhang W, et al. Correlation between palpebral vascular index and carotid atherosclerosis in diabetes patients and its risk factors[J].Clin Med China, 2012, 28(1):28-31.
[12]姜昊,高春华,徐浩钦,等.交感神经与高血压关系的研究进展[J].武警医学, 2017, 28(3):297-300.JiangY,GaoCH,XuHQ,etal.Researchprogressontherelationship betweensympatheticnerveandhypertension[J].MedJChinPeople's Armed Police Forces, 2017, 28(3):297-300.
[13]王文,刘明波,马丽媛,等.我国高血压防治效果与脑卒中死亡率下降[J].中国心血管杂志, 2017, 22(5):313-315.Wang W, Liu MB, Ma LY, et al. The effect of prevention and treatment of hypertensionandthemortalityofstrokeinChina[J].ChinJCardiovasc Med, 2017, 22(5):313-315.
[14]杨丽丽,席波.中国成年居民2000-2015年膳食钠、钾摄入量变化趋势分析[J].中国公共卫生, 2017, 33(8):1249-1253.YangLL,XiB.Analysisonthechangetrendofdietarysodiumand potassium consumption of adult residents in China from 2000 to 2015[J].Chin J Pub Health, 2017, 33(8):1249-1253.
[15]郭统帅,褚超,汪洋,等.高盐摄入及补钾干预对盐敏感个体血压昼夜节律的影响[J].诊断学理论与实践, 2017, 16(6):582-586.Guo TS, Yan C, Wang Y, et al. Effects of high salt intake and potassium supplementationoncircadianrhythmofbloodpressureinsalt-sensitive individuals[J]. J Diagn Concepts Pract, 2017, 16(6):582-586.
[16]周欣,李玉明.限盐补钾,双管齐下——2017年美国高血压指南生活方式干预的新亮点及对我国高血压防控的启示[J].中华高血压杂志,2017, 25(12):1112-1114.ZhouX,LiYM.Limitingsaltandpotassium,two-pronged approach——Newhighlightsof2017Americanhypertensionguideline lifestyleinterventionanditsimplicationsforpreventionandcontrolof hypertension in China[J]. Chin J Hyperten, 2017, 25(12):1112-1114.
[17]朱晨.黄连清降合剂联合降压贴对高血压血浆NO、IGF-1、MIF及血液流变学指标的影响[J].中医药学报, 2017, 45(4):91-94.ZhuC.EffectsofHuanglianqingjiangmixturecombinedwith antihypertensivestickonplasmaNO,IGF-1,MIFandhemorheological parameters in hypertension[J]. Acta Chin Med Pharm, 2017, 45(4):91-94.
[18]李旭东,杨云,张丽.氯沙坦钾对高血压伴糖尿病患者hs-CRP、NO及内皮素-1的影响[J].海南医学, 2018, 29(12):1635-1638.LiXD,YangY,ZhangL.Effectsoflosartanpotassiumonhs-CRP,NO andendothelin-1inpatientswithhypertensionanddiabetesmellitus[J].Hainan Med J, 2018, 29(12):1635-1638.
[2]柏平,朱江,姚艳林,等.同型半胱氨酸、叶酸及维生素B_(12)对高血压及其合并症的临床价值[J].检验医学, 2017, 32(1):41-44.Bai P, Zhu J, Yao YL, et al. Clinical value of homocysteine, folic acid and vitamin B_(12)in hypertension and its comorbidities[J]. Lab Med, 2017,32(1):41-44.
[3]何朝,孙昕霙,张艳艳,等.北京市顺义区高血压及其危险因素流行病学调查[J].中国健康教育, 2017, 33(1):59-63.He C, Sun XW, Zhang YY, et al. Epidemiological survey of hypertension anditsriskfactorsinShunyidistrict,Beijing[J].ChinJHealthEducat,2017, 33(1):59-63.
[4]黄薇,纪坤,梁刚,等.基于居民健康档案的高血压危险因素分析[J].中国健康教育, 2017, 33(6):516-519.HuangW,JiK,LiangG,etal.Analysisofriskfactorsforhypertension basedonresidenthealthrecords[J].ChinJHealthEducat,2017,33(6):516-519.
[5]张月,游凯,赵红叶,等.800例高血压患者相关危险因素分析与防治对策研究[J].中国医药导刊, 2017, 19(7):651-652.ZhangY,YouK,ZhaoHY,etal.Analysisofriskfactorsrelatedto800patientswithhypertensionandpreventionandtreatmentstrategies[J].Chin J Med Guide, 2017, 19(7):651-652.
[6]刘彬,齐涵,刘峥,等.我国北方人群血压盐敏感性的分布频率及其相关影响因素[J].中国循证心血管医学杂志, 2017, 9(4):407-411.LiuB,QiH,LiuW,etal.Distributionfrequencyofbloodpressureand saltsensitivityanditsrelatedinfluencingfactorsinnorthernChina[J].Chin J Evidence-Based Cardiovasc, 2017, 9(4):407-411.
[7]王松,宋金萍,郭丽荣.高盐饮食对血压影响的研究进展[J].心肺血管病杂志, 2018, 37(2):169-171.WangS,SongJP,GuoLR.Researchprogressontheeffectofhighsalt dietonbloodpressure[J].JCardiovascPulmonDis,2018,37(2):169-171.
[8]李瑜,欧阳菊艳,范丽,等.高血压患者24 h尿钠钾比值对同型半胱氨酸水平的影响研究[J].中国全科医学, 2017, 20(22):2746-2750.Li Y, OuYang JY, Fan L, et al. Effect of 24h urinary sodium to potassium ratio on the level of homocysteine in patients with hypertension[J]. Chin Gener Pract, 2017, 20(22):2746-2750.
[9]段翔,边波,孙跃民.高血压患者盐摄入量对尿蛋白和左心室质量指数的影响[J].中国慢性病预防与控制, 2018, 26(5):334-337.Duan X, Bian B, Sun YM. Effects of salt intake on urinary protein and left ventricularmassindexinpatientswithhypertension[J].ChinJPrev Control Chronic Non-Commun Dis, 2018, 26(5):334-337.
[10]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志, 2011, 39(7):583-586.ChinaHypertensionPreventionandTreatmentGuidelinesRevision Committee.Guidelinesforpreventionandtreatmentofhypertensionin China 2010[J]. Chin J Cardiol, 2011, 39(7):583-586.
[11]田国祥,张灵,张薇,等.糖尿病患者心跺血管指数与颈动脉硬化的相关性及其危险因素分析[J].中国综合临床, 2012, 28(1):28-31.Tian GX, Zhang L, Zhang W, et al. Correlation between palpebral vascular index and carotid atherosclerosis in diabetes patients and its risk factors[J].Clin Med China, 2012, 28(1):28-31.
[12]姜昊,高春华,徐浩钦,等.交感神经与高血压关系的研究进展[J].武警医学, 2017, 28(3):297-300.JiangY,GaoCH,XuHQ,etal.Researchprogressontherelationship betweensympatheticnerveandhypertension[J].MedJChinPeople's Armed Police Forces, 2017, 28(3):297-300.
[13]王文,刘明波,马丽媛,等.我国高血压防治效果与脑卒中死亡率下降[J].中国心血管杂志, 2017, 22(5):313-315.Wang W, Liu MB, Ma LY, et al. The effect of prevention and treatment of hypertensionandthemortalityofstrokeinChina[J].ChinJCardiovasc Med, 2017, 22(5):313-315.
[14]杨丽丽,席波.中国成年居民2000-2015年膳食钠、钾摄入量变化趋势分析[J].中国公共卫生, 2017, 33(8):1249-1253.YangLL,XiB.Analysisonthechangetrendofdietarysodiumand potassium consumption of adult residents in China from 2000 to 2015[J].Chin J Pub Health, 2017, 33(8):1249-1253.
[15]郭统帅,褚超,汪洋,等.高盐摄入及补钾干预对盐敏感个体血压昼夜节律的影响[J].诊断学理论与实践, 2017, 16(6):582-586.Guo TS, Yan C, Wang Y, et al. Effects of high salt intake and potassium supplementationoncircadianrhythmofbloodpressureinsalt-sensitive individuals[J]. J Diagn Concepts Pract, 2017, 16(6):582-586.
[16]周欣,李玉明.限盐补钾,双管齐下——2017年美国高血压指南生活方式干预的新亮点及对我国高血压防控的启示[J].中华高血压杂志,2017, 25(12):1112-1114.ZhouX,LiYM.Limitingsaltandpotassium,two-pronged approach——Newhighlightsof2017Americanhypertensionguideline lifestyleinterventionanditsimplicationsforpreventionandcontrolof hypertension in China[J]. Chin J Hyperten, 2017, 25(12):1112-1114.
[17]朱晨.黄连清降合剂联合降压贴对高血压血浆NO、IGF-1、MIF及血液流变学指标的影响[J].中医药学报, 2017, 45(4):91-94.ZhuC.EffectsofHuanglianqingjiangmixturecombinedwith antihypertensivestickonplasmaNO,IGF-1,MIFandhemorheological parameters in hypertension[J]. Acta Chin Med Pharm, 2017, 45(4):91-94.
[18]李旭东,杨云,张丽.氯沙坦钾对高血压伴糖尿病患者hs-CRP、NO及内皮素-1的影响[J].海南医学, 2018, 29(12):1635-1638.LiXD,YangY,ZhangL.Effectsoflosartanpotassiumonhs-CRP,NO andendothelin-1inpatientswithhypertensionanddiabetesmellitus[J].Hainan Med J, 2018, 29(12):1635-1638.