代谢综合征患者血管内皮舒张功能的超声检测  

Evaluation of vascular endothelial function in metabolic syndrome by ultrasonography

作　　者：茅瑾瑜[1] 徐君镛[1] 朱雪萍[1] 章丽洁[1] 

机构地区：[1]上海市普陀区人民医院超声诊断科,200060

出　　处：《上海医学影像》2007年第1期40-42,共3页Shanghai Medical Imaging

摘　　要：目的探讨高分辨力超声在代谢综合征患者血管内皮功能评价中的价值。方法选择42例代谢综合征患者(MS)及正常对照组20例。MS患者根据有无颈动脉斑块分为两组,Ⅰ组(无斑块)23例,Ⅱ组(有斑块)19例。应用Celermajer的方法,通过超声检测肱动脉反应性充血及舌下含服0.5mg硝酸甘油后肱动脉内径变化来评价血管内皮功能。同时记录颈动脉内中膜(IMT)厚度,观察有无斑块形成。结果MS组与对照组之间反应性充血后血管内径变化率均有显著性差异(P<0.01)。MS斑块组与对照组之间含服硝酸甘油后血管内径变化率有显著性差异(P<0.01)。MS斑块组与对照组之间颈动脉内中膜厚度差异有显著性(P<0.01),而MS无斑块组与对照组之间差异无显著性(P>0.05)。单元线性回归分析显示反应性充血后血管内径变化率与患者的年龄、收缩压、舒张压、甘油三脂、血糖、体质指数均呈负相关。结论代谢综合征患者存在血管内皮依赖性舒张功能损伤,颈动脉斑块组非血管内皮舒张功能亦有损害。Objective To evaluate the value of vascular endothelial function in patients with metabolic syndrome by high resolution ultrasonography. Methods Totally 42 patients with metabolic syndrome （MS） and 20 healthy subjects were enrolled in the study. The patients with MS were divided into two subgroups according to the presence of carotid plaque or not. By using Celermajar＇s method, high resolution uhrasonography was used to measure the changes in diameter of hrachial artery during reactive hyperemia and after suhlingnal administration of 0.5mg nitroglycerin. At the same time, intima-medial thickness and carotid plaque of carotid artery were determined. Results There were significant differences of changes in diameter of hrachial artery during reactive hyperemia between control subjects and patients with MS（P〈 0.01 ）, and significant differences of change in diameter of hrachial artery evoked by suhlingnal administration of nitroglycerin between control subjects and MS subgroup Ⅱ were also observed （P〈0.01）. There were significant differences of intima-media thickness between control subjects and MS subgroup Ⅱ , but there were no significant differences of such changes between control subjects and subgroup Ⅰ （P〉0.05）. It was demonstrated by simple linear regression analysis that the percentage of change in diameter of hrachial artery during reactive hyperemia was significantly and negatively related to age, systolic blood pressure, diastolic blood pressure, triglyceride, blood glucose and body mass index in patients with MS. Conclusion The impairment of vascular endothelium-dependent dilatation in patients with MS is apparent. The Dysfunction of endothelium-independent dilatation can be seen in the patients with carotid plaque as well.

关 键 词：高分辨率超声 代谢综合征 内皮功能 超声检测 

分 类 号：R544.1[医药卫生—心血管疾病]