餐后高甘油三酯血症对老年冠心病患者血管内皮功能的影响  

Influence of postprandial hypertriglyceridemia on the endothelial function in elderly patients with coronary heart disease

作　　者：刘玲[1] 赵水平[1] 高梅[2] 李玉玲[3] 

机构地区：[1]中南大学湘雅二医院心血管内科,长沙410011 [2]中南大学湘雅二医院超声科,长沙410011 [3]中南大学湘雅二医院营养科,长沙410011

出　　处：《湖南医科大学学报》2002年第3期259-262,共4页Bulletin of Hunan Medical University

摘　　要：目的 :探讨老年冠心病患者的高脂餐后颈动脉粥样硬化和血管内皮功能的变化。方法 :采用高分辨超声检测技术观察老年冠心病患者和老年健康人组高脂餐前后的颈动脉内 中膜厚度 (IMTc)以及肱动脉血流介导的血管舒张功能 (FMD)。结果 :老年冠心病组较老年健康人组具有显著增加的IMTc(P <0 .0 1)和明显受损的FMD(P <0 .0 5 )。两组受试者高脂餐后血清甘油三酯水平显著升高 ,老年冠心病组的甘油三酯峰反应显著高于老年健康人组(P <0 .0 5 )。两组受试者高脂餐后IMTc无明显变化 ,FMD均显著受损 (P <0 .0 0 1) ;老年冠心病患者的FMD下降程度明显高于老年健康人组 (P <0 .0 5 )。高脂餐后甘油三酯峰反应与空腹IMTc和FMD下降程度显著正相关 (P <0 .0 1)。结论 :高脂餐后富含甘油三酯脂蛋白代谢紊乱通过影响血管内皮功能促进动脉粥样硬化。Objective To explore the changes of carotid atherosclerosis and the endothelial function after a high fat meal in elderly patients with coronary artery disease (CAD). Methods The carotid intima media thickness ( IMTc) and the brachial artery flow mediated vasodilation ( FMD ) before and after a high fat meal were measured by the high resolution ultrasound technique in 20 elderly patients with CAD and 22 healthy elderly subjects. Results The CAD patients had a higher IMTc (P<0.01) and impaired FMD (P<0.05) compared with the healthy subjects. The serum triglyceride level increased in the two groups after the meal. The CAD patients had a higher triglyceride peak response (TGPR) than the healthy subjects (P<0.05). The IMTc of the two groups had no change before and after the meal. The postprandial FMD significantly aggravated in the two groups (P<0.001); and the percent decrement of FMD in the CAD patients was obviously higher than that in the healthy subjects (P<0.05). The postprandial TGPR was positively correlated with the fasting IMTc and the postprandial percent decrement of FMD (P<0.01). Conclusion The disordered postprandial metabolism of triglyceride riched lipoproteins may play an atherogenic role by inducing endothelial dysfunction.

关 键 词：高甘油三酯血症 冠心病 血管内皮功能 老年人 动脉粥样硬化 

分 类 号：R541.4[医药卫生—心血管疾病]