高分辨率超声评估血管内皮功能的价值:不同时期动脉粥样硬化兔血管内皮功能的超声改变与病理对照

Value of high resolution ultrasound in evaluation of vascular endothelial function: Ultrasound changes and pathological control of vascular endothelial function in rabbits with artherosclerosis of different periods

目的:运用高分辨超声检测动脉粥样硬化不同时期兔髂外动脉内皮功能,以期为超声评价血管内皮细胞功能提供实验方法学的相关参数依据。方法:实验于2005-02/06在中国医科大学第一附属医院心功能科、中国医科大学实验动物部及病理科完成。日本大耳白兔38只,对照组(8只)和动脉粥样硬化模型4周组(10只)、8周组(10只)、12周组(10只)。应用Hp5500彩色超声诊断仪检测动脉粥样硬化不同时期兔的髂外动脉血管内皮依赖性舒张功能和血管内皮非依赖性舒张功能,并同期进行病理学检查(电镜及光镜)及血脂(总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)测定。结果:实验兔35只进入统计。①随着动脉粥样硬化的进展,对照组、动脉粥样硬化模型4,8,12周组血脂逐渐升高[总胆固醇:(1.35±0.33),(13.54±3.48),(35.74±7.35),(33.81±5.57)mmol/L;高密度脂蛋白胆固醇:(0.83±0.27),(1.68±0.41),(2.64±0.33),(3.86±1.68)mmol/L;低密度脂蛋白胆固醇:(0.36±0.17),(11.39±3.52),(15.78±2.74),(18.10±4.36)mmol/L,P<0.01或0.05]。②随着动脉粥样硬化的进展,对照组、动脉粥样硬化模型4,8,12周组血管内皮依赖性舒张功能和内皮非依赖性舒张功能先后出现不同程度损伤且逐渐加重[血管内皮依赖性舒张功能:(16.58±2.64),(8.17±1.02),(4.92±0.81),(1.19±0.47)%;血管内皮非依赖性舒张功能:(11.55±2.20),(9.87±2.36),(6.92±1.31),(4.18±0.74)%,P<0.01]。③动脉粥样硬化各时期皆伴随不同程度的病理改变。结论:动脉粥样硬化是一种形态和功能损害共存的病变,早期即有血管内皮功能损伤,并有相应的病理改变。超声技术是评价血管内皮功能的有效方法。

AIM： To inspect the endothelial function of arteria iliaca externa in rabbits with artherosclerosis （ATS） of different periods with high resolution ultrasound, so as to provide relative parameter datas of empirical method for evaluation on function of vascular endothelial cells with ultrasound. METHODS： The experiment was conducted in the Department of Cardiac Function, First Affiliated Hospital of China Medical University as well as Experimental Animal Department and Department of Pathology, China Medical University from Febuary to June 2005. Thirty-eight Japanese white rabbits with big ears were randomly divided into control group （n=8） , 4-week ATS model group （n=10）, 8-week ATS model group （n=10） and 12-week ATS model group （n=10）. Dependent and indepent diastolic function of blood vessel endothelium （BVE） in arteria ihaca extema of rabbits in different periods of ATS were inspected with Hp5500 color ultrasonoscope, meanwhile, pathological examination （electron microscope and light microscope） as well.,as assessment of blood lipid [total cholesterol （TC）, high density lipoprotein cholesterol （HDL-C） and low density lipeprotein cholesterol （LDL-C） were performed. RESULTS： A total of 35 experimental rabbits were involved in the statistics. ① As the progressing of ATS, the blood lipid in the control group, 4, 8, 12 weeks ATS model groups increased gradually [level of TC： （1.35±0.33）, （13.54±3.48）, （35.74±7.35）, （33.81±5.57） mmol/L;Level of HDL-C： （0.83±0.27）, （ 1.68±0.41 ）, （2.64±0.33）, （3.86±1.68） mmol/L;Level of LDL-C： （0.36±0.17）, （ 11.39±3.52）, （ 15.78±2.74）, （18.10±4.36） mmol/L, P 〈 0.01 or 0.05]. ② As the progressing of ATS, there were injuries of different degrees in dependent and indepent diastolic function of BVE in the control group and 4, 8, 12 weeks ATS model groups, and the injury gradually aggravated [dependent diastolic function of BVE： （16.58±2.64）, （8.17±1.02 ）, （4.92±0.81 ）, （ 1.19±0.47 ）%; Independent diastolic function of BVE： （ 11.55±2.20）, （9.87±2.36）, （6.92±1.31）, （4.18±0.74）%,P 〈 0.01].③ There were pathological changes of different degree in each period of ATS. CONCLUSION： ATS is amorphous and functional lesion with functional injury of BVE in early period as well as corresponding pathological changes. Ultrasonography is an effective method to evaluate the function of BVE.