老年全身炎症反应综合征患者肱动脉血管舒张功能的变化  

Changes of brachial artery diastolic function in aged patients with systemic inflammatory reaction syndrome

作　　者：王莉[1] 王晓[1] 向慧娟[2] 

机构地区：[1]广州军区武汉总医院干部病房二科,湖北武汉430070 [2]广州军区武汉总医院超声影像科,湖北武汉430070

出　　处：《军医进修学院学报》2012年第6期604-606,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的探讨血管内皮舒张功能在全身炎症反应综合征(SIRS)老年患者中的变化。方法选择82例SIRS老年患者,分为生存组(n=58)和死亡组(n=24),同时选择22例非SIRS老年患者作为对照,分别检测肿瘤坏死因子(TNF-α)、白细胞介素-1(IL-1)、血浆内皮素-1(ET-1)和C反应蛋白(CRP),并采用高分辨血管外超声法检测肱动脉介导的内皮依赖性血管舒张功能(FMD)和硝酸甘油介导的内皮非依赖性血管舒张功能(NMD)。结果 SIRS组中TNF-α、IL-1、ET-1、CRP明显升高,差异有统计学意义,在死亡组中,上述指标较生存组高(P<0.01),差异有统计学意义(P<0.05)。SIRS组FMD较对照组显著降低(2.21±0.18 vs 2.80±0.21,P<0.01),且死亡组中FMD较生存组降低。SIRS组NMD较对照组明显增加(P<0.01),但死亡组中NMD较生存组下降(P<0.01)。TNF-α、IL-1、ET-1、CRP与内皮依赖性血管舒张功能呈负相关(P<0.01)。结论 SIRS患者血管内皮依赖性舒张功能(FMD)明显受损,受损程度与病情严重程度相关。Objective To study the changes of vascular endothelial dilation function in aged patients with systemic inflammatory reaction syndrome（SIRS）.Methods Eighty-two aged patients with SIRS were divided into survival group（n=58） and death group（n=24）.Twenty-two non-SIRS patients served as a control group.Their plasma levels of endothelin-1（ET-1）,C-reactive protein（CRP）,interleukin-1（IL-1） and TNF-α were measured.Endothelium-dependent vascular dilation function mediated by brachial artery and nitroglycerine was observed by high resolution ultrasonography.Results The plasma levels of TNF-α,ET-1,IL-1 and CRP were significantly higher in SIRS patients and survival group than in controls（P0.05）.The endothelium-dependent vascular dilation function mediated by brachial artery was significantly lower in SIRS patients than in controls（2.21±0.18 vs 2.80±0.21,P0.01） and in death group than in survival group,while the endothelium-dependent vascular dilation function mediated by nitroglycerine was significantly higher in SIRS patients than in controls（P0.01） and lower in death group than in survival group（P0.01）.The plasma levels of TNF-α,ET-1,IL-1 and CRP were negatively correlated with endothelium-dependent vascular dilation function（P0.01）.Conclusion The endothelium-dependent vascular dilation function of patients with SIRS is obviously injured,which is correlated with the severity of SIRS.

关 键 词：全身炎症反应综合征 老年 血管内皮功能 

分 类 号：R592[医药卫生—老年医学]