内皮功能异常在X综合征发病中的作用  

The Significance of Endothelial Dysfunction in the Pathogenesis of Syndrome X

作　　者：张砚[1] 施文红 王丹阳[3] 杨洪晶[1] 侯宇[1] 

机构地区：[1]沈阳医学院附属中心医院心内科,110024 [2]于洪区人民医院内科 [3]沈阳医学院附属中心医院电诊科

出　　处：《中国误诊学杂志》2003年第6期806-808,共3页Chinese Journal of Misdiagnostics

摘　　要：目的　探讨内皮功能异常与 X综合征病因上的联系及其临床意义。方法　测定了 16例 X综合征患者的血浆一氧化氮 (NO)、内皮素 (ET- 1)水平 ,并采用高分辨超声技术检测其血管内皮功能 ,与 18例正常人 (对照组 )作比较。结果　 X综合征组血浆 ET- 1含量明显高于对照组 (85 .2± 2 1.2比 6 2 .6± 2 0 .0 ,P<0 .0 1) ;NO差异无显著性 (85 .0±2 0 .1比 90 .5± 2 5 .3,P>0 .0 5 ) ;X综合征组肱动脉血流介导性内皮舒张功能较对照组明显减退 [(4 .5± 1.5 ) %比 (13.1± 3.6 ) % ,P<0 .0 1],而两组对硝酸甘油的反应差异无显著性 [(2 2 .3± 7.7) %比 (2 1.2± 7.0 ) % ,P>0 .0 5 ];肱动脉血管内皮依赖性舒张功能与 ET- 1含量呈明显负相关 (r=- 0 .80 5 ,P<0 .0 1) ,与 NO/ET- 1呈正相关 (r=0 .6 92 ,P<0 .0 1) ,与NO基本无相关性 (r=0 .2 6 2 ,P<0 .0 1)。结论　冠脉微血管内皮功能异常导致其扩张储备功能降低在 X综合征发病中起着重要作用。Objective To study the significance of the endothelial dysfunction in the pathogensis of syndrome X.Methods The concentrations of plasma endothelin 1 and nitric oxide were assayed in 16 patients with syndrome X and 18 healthy subjects. The endothelium dependent vasodilatation function was also measured by high resolution ultrasound in the two groups.Results The levels of plasma ET1 in the patients with syndromw X were much higher than those in the healthy subjects(85.2±21.2 vs 62.6±20.0,P<0.01);No significant difference was found in NO levels in both groups;In pathens with syndrome X,flow mediated dilation in artery was much reduced as compared with that in the health subjects[(4.5±1.5)% vs(13.1±3.6)%,P<0.01);However, there was no significant difference in response to nitroglycerin between the two groups[(22.3±7.7)% vs(21.2±7.0)%,P>0.05].The changes of endothelium dependent vascodilatation function in artery were negatively correlated with the ET 1 values(r= 0.805,P<0.01), positively correlated with NO/ET1 (r= 0.692,P<0.01), and not correlated with NO level(r=0.262,P<0.01).Conclusions It was suggested that the decrease of function of vasodilatation reserve induced by abnormality of coronary microvessel endothelia function could play a important role in the pathogenesis of X syndrome.

关 键 词：X综合征/血液 血管舒张 X综合征/超声检查 内皮缩血管肽类/血液 一氧化氮/血液 

分 类 号：R541.4[医药卫生—心血管疾病]