冠心病患者动脉弹性与血管舒张功能受损的关系

The relationship between arterial elasticity and impaired vasodilation in patients with coronary artery disease

目的探讨冠心病患者动脉弹性和内皮与非内皮依赖性血管舒张功能的关系。方法采用高分辨率血管超声法检测30例冠心病患者(冠心病组)与健康体检非冠心病者30例(对照组)肱动脉血流介导的内皮依赖性血管舒张功能及硝酸甘油介导的非内皮依赖性血管舒张功能;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)。结果冠心病组与对照组的C1差异无显著性意义,但冠心病组的C2明显低于对照组,冠心病组内皮依赖性血管舒张功能与非内皮依赖性血管舒张功能均明显低于对照组;冠心病组C2不仅与内皮依赖性血管舒张功能呈正相关,且同非内皮依赖性血管舒张功能呈正相关。结论冠心病组C2降低,C2降低不仅同血管内皮功能的受损相关,而且也受非内皮因素的影响,提示C2反映总体血管舒张功能受损的程度。

Objective To investigate the relationship between arterial elasticity and endothelium-dependent and -independent vasodilation 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） and nitroglycerin medi- ated dilation（NMD） of the brachial artery were evaluated by ultrasound Doppler flow method. They also underwent a non-invasive assessment of elasticity index of large artery（C1） and elasticity index of small artery（C2） using pulse wave analysis. Results C1 was similar between the two groups. However, C2 was significantly reduced in CAD group compared with control group. FMD and NMD were significantly reduced in CAD group compared with control group. There was a positive correlation between reduced C2 and impaired FMD and NMD. Conclusions The patients with CAD have reduced C2 which was closely correlated with impaired endothelium-dependent and endothelitml-independent vasodilation. The present study suggests that measurement of C2 may in general be used as a novel approach for the evaluation of vasodilation.