老年冠心病患者冠状动脉病变程度与血管内皮功能的关系  

Relationship between the vascular endothelial dysfunction and severity of coronary artery lesion in old patients with coronary artery disease

作　　者：谭国娟[1] 智光[1] 盖鲁粤[1] 杨庭树[1] 刘宏斌[1] 

机构地区：[1]解放军总医院南楼临床部超声科,北京100853

出　　处：《中华老年心脑血管病杂志》2007年第12期820-822,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家973基金资助项目(G2000057006)

摘　　要：目的探讨老年冠心病患者冠状动脉病变程度与血管内皮功能的关系。方法应用高分辨率彩色多普勒超声诊断仪对176例健康老年人(健康对照组)及161例老年冠心病患者(冠心病组)进行肱动脉血管内皮功能的超声检测,并对老年冠心病组患者冠状动脉病变支数与肱动脉血管内皮功能进行分析。结果反应性充血(reactive hyperemia,RH)后血管内径的变化率(flow-mediated diameter,FMD)及RH在老年冠心病组分别为6.05%及56.29%,而在健康对照组则分别为16.12%及127.23%,差异有显著性意义(P<0.001)。FMD在1支冠状动脉病变时为6.37%,在2支冠状动脉病变时下降为5.69%,而在3支冠状动脉病变时仅为3.94%;RH在1支冠状动脉病变时为62.19%,在2支冠状动脉病变时下降为53.45%,而在3支冠状动脉病变时仅为40.13%,差异有显著性意义(P<0.01)。结论老年冠心病组血管内皮功能较健康对照组明显减退。随着冠心病患者冠状动脉血管病变程度的增加,血管内皮功能进一步减退。血管内皮功能的减退在一定程度上可能反映了冠状动脉血管病变的严重程度。Objective To explore the relationship between extent and severity of coronary artery disease and vascular endothelial function. Methods 176 normal volunteers and 161 old patients with coronary heart disease （CHD） were enrolled in this study. Their vascular endothelial function of brachial artery was examined using high resolution color Doppler ultrasonography. FMD （flow-mediated diameter） and RH （reactive hyperemia） in brachial artery were assessed. Results FMD and RH were 6. 05% and 56. 29% in the group with CHD,while in the normal subjects group,they were 16.12% and 127.23% respectively, P 〈0. 001. FMD was 6. 37%,5.69% and 3.94% in 1 branch,2 branches and 3 branches coronary artery disease groups respectively. RH was 61.19%,53.45%,40. 13% in 1 branch,2 branches and 3 branches coronary artery disease groups respectively, P〈0.01. Conclusion Vascular endothelial function was significantly lower in old patients with CHD than in healthy person. In the old patients with CHD, the endothelial function steps down with increasing the number of diseased coronary artery branches.

关 键 词：冠状动脉疾病 内皮 血管 肱动脉 超声检查 多普勒 彩色 

分 类 号：R541.4[医药卫生—心血管疾病]