超声检测阻塞性睡眠呼吸暂停综合征患者颈总动脉内-中膜厚度与血管内皮舒张功能的临床意义  

Clinical Implication of High Frequency Ultrasound Detection in Carotid Intima-media Thickness and Vascular Endothelial Function in Patients with Obstructive Sleep Apnea Syndrome

作　　者：张玉萍[1] 马春梅[2] 贾德静[3] 张莉[1] 

机构地区：[1]中国航天科工集团七三一医院超声,北京市100074 [2]武警总医院心内科 [3]中国航天科工集团七三一医院耳鼻喉科

出　　处：《中国超声医学杂志》2009年第9期877-880,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 研究阻塞性睡眠呼吸暂停综合征（OSAS）患者血管内皮舒张功能与颈总动脉内-中膜厚度及斑块的变化。方法应用高频超声检测30例OSAS患者及20例健康自愿者颈总动脉内-中膜厚度（IMT）及粥样硬化斑块，同时检测两组基础状态、反应性充血及舌下含硝酸甘油的内皮功能并进行比较。结果OSAS组颈总动脉IMT及粥样硬化斑块的发生率明显高于对照组（P〈0．01）；OSAS组收缩压及空腹血糖水平明显高于对照组（P〈0．05）。OSAS组反应性充血介导和硝酸甘油引起的肱动脉舒张反应均明显低于对照组（P〈0．01）。结论OSAS患者颈总动脉粥样硬化发生率明显增加；OSAS患者存在内皮依赖性及非内皮依赖性舒张功能明显受损。颈动脉超声及血管内皮舒张功能检查可为合并有冠心病危险因素的OSAS患者预防和早期发现冠心病提供依据，还可作为监测和评估病情变化的指标。Objective To study the changes in vascular endothelial function and intima-media thickness and plaque of the carotid arteries in patients with obstructive sleep Apenea syndrome （OSAS） with the aid of high resolution ultrasound examination. Methods 30 patients with OSAS and 20 normal subjects （control group） were selected. Carotid arteries intima-media thickness （IMT） and atherosclerotic plaques were measured with high frequency ultrasound. Diameter of the brachial arteries during resting state, reactive hyperaemia and after sublingual administration of nitroglycerin were determined at the same time. Results The intima-media thickness of OSAS group was significantly higher than that of the control group. Atherosclerotic plaques were mostly found in OSAS group. The level of systolic blood pressure （SBP） and blood glucoses was higher in OSAS group than that of the control group. The flow-mediated dilatation and nitroglycerin-induced dilatation of brachial arteries in patients with OSAS were significantly reduced compared with those in the control group （P〈0.01） . Conclusions There were higher incidence of carotid artery atherosclerosis and impaired vascular endothelial function in patients with OSAS. High frequency ultrasonography may provide diagnostic clue to coronary artery disease in earlier period with OSAS by assessing carotid artery atherosclerosis and the endothelial vasodilatation function and also monitor state of an illness in persons with risk factors of CHD.

关 键 词：阻塞性睡眠呼吸暂停综合征 颈总动脉内中膜厚度 内皮舒张功能 超声 

分 类 号：R766.43[医药卫生—耳鼻咽喉科] R544.1[医药卫生—临床医学]