冠心病患者血管内皮功能障碍与动脉弹性关系的研究

Impaired-endothelium dependent vasodilation and arterial elasticity in patients with coronary artery disease

目的 探讨冠心病患者血管内皮功能障碍与动脉弹性的关系。方法 采用高分辨率血管超声法检测 30例冠心病患者与 30例正常对照组肱动脉血流介导的内皮依赖性血管舒张功能(FMD);应用动脉弹性功能检测仪测定受试者的大动脉弹性指数 (C1 )和小动脉弹性指数 (C2 )。结果 冠心病组血流介导的肱动脉舒张反应明显低于对照组[ (5 17±2 13)% 与 (11 10±4 36)%,P<0 05];冠心病组与正常对照组的C1 差异无统计学意义 [ ( 11 59±4 56 )ml/mmHg( 1mmHg=0 133kPa) ×10与 (12 11±3 82)ml/mmHg×10, P>0 05],但冠心病组的C2 明显低于正常对照组[ (4 20±1 80)ml/mmHg×100与 (6 26±2 36)ml/mmHg×100, P<0 05],冠心病组血流介导的肱动脉舒张反应与C2 呈正相关(r=0 53, P<0 05)。结论 冠心病患者肱动脉内皮依赖血管舒张功能受损和C2 降低,且两者之间呈正相关,提示C2 可作为一种评价血管内皮功能的新指标。

Objective To investigate the change in endothelium dependent vasodilation and arterial elasticity and the association between them in patients with coronary artery disease(CAD) Methods Thirty patients with CAD and thirty control subjects were recruited for this study Flow mediated dilation(FMD) in the brachial artery was evaluated by ultrasound Doppler flow method They also underwent a non invasive assessment of C 1 large artery and C 2 small artery indices by using pulse wave analysis Results FMD was significantly reduced in CAD group compared with that in control group[(5 17±2 13)% vs (11 1±4 36)%, P <0 05], C 1 large artery elasticity index was similar between the two groups [(11 59± 4 56) ml/mm Hg ×10 vs (12 11±3 82) ml/mm Hg ×10, P >0 05] However, C 2 small artery elasticity index was significantly reduced in CAD group compared with that in control group[(4 20±1 80) ml/mm Hg ×100 vs (6 26±2 36)ml/mm Hg ×100, P <0 05] There was a positive association between reduced C 2 small artery elasticity index and impaired FMD ( r =0 53, P <0 05) Conclusions There were impaired endothelium dependent vasodilation and reduced C 2 small artery elasticity index in the patients with CAD, which were closely correlated with each other The present study suggested that the measurement of C 2 small artery elasticity might be used as a novel index for the determination of endothelial function