超声检测冠心病患者血管功能的临床意义

The clinical significance of assessing vascular function in patient with coronary heart disease by using ultrasonography

目的探讨多普勒超声检查方法无创检测冠心病患者血管内皮功能和平滑肌功能的临床意义。方法检测56例冠心病患者和38例正常人的肱动脉舒张功能:反应性充血后肱动脉血管舒张(FMD)和舌下含服硝酸甘油后的血管舒张(NID),同时检测血浆内皮素(ET)、一氧化氮浓度(NO),并进行对比分析。结果(1)冠心病组内皮依赖性血流介导的和非内皮依赖性硝酸甘油介导的肱动脉舒张反应均明显低于正常对照组(均P<0.01)。(2)冠心病组FMD与NO呈正相关(r=0.54,P<0.01);与肱动脉基础内径和ET呈负相关(r=-0.21,P<0.05,r=-0.47,P<0.01)。而NID与肱动脉基础内径呈负相关(r=-0.41,P<0.01),与FMD呈正相关(r=0.43,P<0.01)。结论冠心病患者肱动脉血管内皮功能和平滑肌功能均受损,肱动脉舒张功能的测定对冠心病的预测和防治具有重要意义。

Objective To investigate the clinical significance of assessing endothelial and smooth muscle function in patients with coronary heart disease（CHD） by using ultrasonography, Methods The subject consisted of 56 CHD patients and 48 matched normal controls. The brachial artery flow mediated dilatation （FMD） and nitroglycerin-induced dilatation （NID） were investigated, Plasma endothelia （ET） and nitric oxide （NO） were measured.Results FMD and NID in CHD group were significantly lower than that of control （all P〈0,01）, while ET level was greater （P〈0,01）, NO level was lower （P〈0.01）. FMD was positively related with NO（r= 0.54, P〈0.01） and negatively related with ET（r=0.47, P 〈 0.01）. NID was positively related with FMD（r = 0.43, P〈 0,01 ）. Conclusion The present study suggests that both endothelial and smooth muscle function in patients with CHD are impaired. The determinations on brachial artery vasodilatation function are having great significance on predicting and curing CHD.