维生素C对高脂餐后内皮依赖性血管舒张功能的保护作用  

Effect of vitamin C on endothelium-dependent vasodilation in patients with coronary heart disease after a high-fat meal

作　　者：赵水平[1] 刘玲[1] 高梅[2] 李向平[1] 周启昌[2] 李玉玲[3] 夏冰[3] 

机构地区：[1]湖南医科大学附属第二医院心内科,长沙410011 [2]湖南医科大学附属第二医院B超室,长沙410011 [3]湖南医科大学附属第二医院营养科,长沙410011

出　　处：《中华心血管病杂志》2001年第1期29-32,共4页Chinese Journal of Cardiology

摘　　要：目的　探讨维生素C对高脂餐后内皮依赖性血管舒张功能变化的影响。方法　 74例冠心病患者被随机分为两组 ,分别在禁食 12h后进食高脂餐与维生素C 2g(A组 ,n =37)或单纯的高脂餐 (B组 ,n =37)。分别采集餐前及餐后 2、4、5、7h静脉血标本 ,用以测定血清甘油三酯 (TG)、总胆固醇、低密度脂蛋白 胆固醇 (LDL C)、高密度脂蛋白 胆固醇 (HDL C)浓度。采用高分辨血管外超声法检测餐前及餐后 4h肱动脉血流介导的内皮依赖性血管舒张功能和硝酸甘油介导的内皮非依赖性血管舒张功能。结果　冠心病患者空腹状态的内皮依赖性血管舒张功能显著受损。服用维生素C 2g(A组 )餐后 4h内皮依赖性血管舒张功能较餐前无显著变化 [(3.6 3± 0 .5 9) %∶(4 .5 1± 0 .49) % ,P =0 0 6 4];未服用维生素C 2g(B组 )餐后 4h内皮依赖性血管舒张功能较餐前相比严重受损 [(3.5 8±0 6 3) %∶(0 .5 8± 0 .40 ) % ,P <0 .0 0 1]。高脂餐后硝酸甘油介导的内皮非依赖性血管舒张功能的变化无统计学意义 [A组 :(19.48± 1.38) %∶(2 0 .2 5± 1.2 1) % ,P =0 .498;B组 :(18.71± 1.5 3) %∶(16 .36±1 5 3) % ,P =0 .135 ]。两组受试者餐后 2～ 7h血清TG浓度均显著升高。经相关分析结果显示 :B组受试者的餐后 2h血清TG浓度增高值与餐后Objective To evaluate the effect of a single oral dose of vitamin C on postprandially impaired endothelium dependent vasodilatation in patients with coronary heart disease (CHD) after a single high fat meal. Methods Seventy four patients with CHD were randomly divided into two groups. Patients in group A ( n =37) accepted 2 grams of vitamin C, whereas in group B ( n =37) did not treated with vitamin C after a high fat meal. The serum levels of triglyceride, total cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol in fasting and at 2, 4, 5, 7 hours after the high fat meal were measured. Endothelium dependent vasodilatation (flow mediated vasodilatation) and endothelium independent vasodilatation (nitroglycerin induced vasodilatation)was assessed in the brachial artery by high resolution ultrasound technique before eating and at 4 hours postprandially. Results The fasting endothelium dependent vasodilatations were impaired in CHD patients. The postprandial serum triglyceride concentration increased significantly at 2-7 hours after the high fat meal in all subjects. The impaired endothelium dependent vasodilatation restored [(3.63±0.59)% vs (4.51±0.49)%, P =0 064] in Group A, but significantly aggravated [(3.58±0.63)% vs (0.58±0.40)%, P <0.001] in Group B. The postprandial endothelium independent vasodilatation has no obvious change in the two groups compared with that in the fasting state [Group A:(19.48±1.38)% vs(20.25±1.21)%, P =0.498;Group B:(18.71± 1.53)% vs(16.36±1.53)%, P =0.135]. The decrement of postprandial flow mediated vasodilatation positively correlated with the increment of 2 hour serum TG concentration ( r =0.395, P <0.02). Conclusion The impaired endothelium dependent vasodilatation aggravated in CHD patients after a high fat meal, and vitamin C treatment has a promising benefit to CHD patients.

关 键 词：抗坏血酸 膳食脂肪类 血管舒张 维生素C 内皮素 

分 类 号：R541.4[医药卫生—心血管疾病]