高分辨超声技术评价冠心病患者血管内皮功能的临床研究  

Clinic institute of vasodilator function in patients with coronary heart diseases by ultrasonic

作　　者：杨梅[1] 于杰[2] 杨玉双[1] 杨萍[1] 

机构地区：[1]吉林大学中日联谊医院心内科 [2]吉林大学中日联谊医院电诊科,吉林长春130021

出　　处：《中国实验诊断学》2007年第4期448-451,共4页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省科技厅基础处项目(200505173)

摘　　要：目的探讨冠心病患者血管内皮依赖性及非内皮依赖性舒张功能的变化。方法对30名冠心病患者和20名正常人采用高分辨超声技术测量反应性充血和含服硝酸甘油后肱动脉的内径变化,评价血流介导的肱动脉舒张功能和硝酸甘油介导的肱动脉舒张功能。结果冠心病患者组的血流介导的肱动脉舒张反应比(3.68±1.91%)和硝酸甘油介导的肱动脉舒张反应比(16.33±3.33%)与对照组比较(分别为6.37±3.59%和23.31±6.63%)显著低于对照组(P<0.01)。另外,线性回归分析结果显示:冠心病患者组的血流介导的肱动脉舒张功能与低密度脂蛋白、肱动脉基础直径呈负相关(r=-0.377,P<0.05;r=-0.422,P<0.05),硝酸甘油介导的肱动脉舒张反应与肱动脉基础直径呈负相关(r=-0.386,P<0.05)。结论冠心病患者血管内皮依赖性及非内皮依赖性舒张功能均受损,肱动脉超声法检测血管舒张功能可用于对冠心病患者内皮功能的评价。Objective To explore the endothelium-dependent and endothelium-independent vasodilator changes in coronary heart disease（CHD）. Methods A non-invasive high-resolution ultrasound was used to detect the dilation changes of brachial arteries during reactive hyperemia and after sublingual nitroglycerin. Results How-mediated dilation （FMD）（3.68 ± 1.91% ） and nitroglycerinmediated dilation of brachial artcries（NMD） （ 16.33 ± 3.33%）in Patients with CHD were much reduced compared with control group （6.37 ± 3.59% vs 23.31 ± 6.63） showd significantly reduced endothelium-dependent and endothelium-independent vaso-dilator function as compared with normal subjects. FMD was inversely associated with LDL and braehial artery size（ r = -0. 377, P 〈 0.05; r= - 0.422, P 〈0.05）,NMD was inversely associated with LDL-C and brachial artery size（r= - 0.386, P 〈 0.05）by linear stepwise regression analysis. Conclusion Both endothelium-dependent and endothelium-independent vasodilation is impaired in patients with coronary heart disease. Ultrasonic measure brachial artery dilation was promising technique to diagnosis and therapy of CHD.

关 键 词：内皮功能 冠心病 高分辨超声 血管 

分 类 号：R541.4[医药卫生—心血管疾病]