冠心病患者血管内皮功能与颈总动脉内中膜厚度的相关性研究  

Correlation between vascular endothelial function and thickness of intima-media of common carotid artery in coronary artery disease

作　　者：王少特[1] 雷志辉[1] 李莉[1] 王彦[1] 

机构地区：[1]武警湖北总队医院超声科,武汉430061

出　　处：《武警医学》2006年第1期14-17,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的研究冠心病患者颈动脉内-中膜厚度、血管弹性与肱动脉血管内皮功能。方法将研究对象分为3组,Ⅰ组为30名健康人,Ⅱ组为心绞痛型冠心病患者30例,Ⅲ组为冠心病心肌梗死患者30例,用高频超声测量颈动脉内-中膜厚度、收缩期颈动脉内径(DS)、舒张期颈动脉内径(DC),计算颈总动脉壁弹性的相关参数:可扩张度(DC)、顺应性(CC);观察受检者的肱动脉充血反应性扩张(DTRH)和含服硝酸甘油后血管内径的变化(DTNG),并进行对比分析。结果冠心病心肌梗死患者颈动脉内-中膜厚度较心绞痛型冠心病患者、正常对照组增厚(P<0.01),血管弹性与血管内皮功能明显减低(P<0.01),心绞痛型冠心病患者较正常对照组血管内皮功能明显减低(P<0.01),血管内皮功能与颈动脉内-中膜厚度之间有较大相关性,呈负相关,与颈总动脉壁可扩张度、顺应性有较大相关性,呈正相关。结论冠心病患者肱动脉依赖性血管内皮细胞功能减退早于颈动脉内-中膜厚度变化,可与颈总动脉内中膜厚度、血管弹性一起作为监测冠心病病情发展变化及判断预后的客观指标。Objective To study the relationship beween the intima - media thickness （IMT）, vascular elasticity of common carotid artery（CCA） and the vasular endothelial function of brachial artery in patients with coronary artery disease. Methods The subjects were divided into three groups： group Ⅰ consisting of 30 normal volunteers, group Ⅱ 30 patients with angina pectoris, and group Ⅲ 30 patients with myocardial infarction（ MI）. We measured the IMT, systolic diameter and diastolic diameters of CCA with high - frequency ultrasound, calculated the parameters of elasticity, such as dilatablity and compliancy of CCA. Then we investigated and compared brachial artery dilatation induced by reactive hyperemia with that hy sublingual nitroglycerin. Results .As compared with angina petoris group and normal group, the IMT in MI group was increased （ P 〈0.01） , vascular elasticity and wscular endothelial fimction were reduced significantly （ P 〈0.01）, Compared with the normal group, the vascular endothelial function in angina pectoris group was reduced significantly （ P 〈 0.01） ,There. were significant negative correlations between vascular endothelial function and IMT of common carotid artery （CCA）, but positive correlations between vascular endothelial function and dilatablity, compliancy of CCA. Conclusions Brachial - artery dependent reduced vascular endothelial function, IMT and vascular elasticity of common carotid artery provide prognostic indices for coronary artery disease.

关 键 词：冠心病 颈总动脉 内中膜厚度 血管弹性 内皮功能 

分 类 号：R543.3[医药卫生—心血管疾病] R541.4[医药卫生—内科学]