老年高血压病合并脑梗死血管内皮依赖性舒张功能的无创评价

Non-Invasive Assessment of Endothelium-Dependent Vasodilation in Elderly Patients with both Hypertension and Cerebral Infarction

目的了解老年高血压病合并脑梗死患者血管内皮依赖性舒张功能。方法对68例高血压病合并脑梗死老年患者(高血压病组)及46例无高血压病、糖尿病和心脑血管疾病的老年患者(对照组)进行血管内皮依赖性舒张功能无创检查,测定两组患者血管内皮依赖性舒张功能并进行对照分析。结果老年高血压病合并脑梗死患者反应性充血诱发的肱动脉内径百分变化率明显低于对照组(P<0.01),硝酸甘油诱发的肱动脉内径百分变化率与对照组无明显差异(P>0.05)。结论老年高血压病合并脑梗死患者存在严重血管内皮依赖性舒张功能障碍,超声检查对评价血管内皮依赖性舒张功能有重要价值。

Objective To evaluate the endothelium-dependent vasodilation function in elderly patients with both hypertensive disease and cerebral infarction. Methods Emeasurements of brachial artery diameter were performed by high-resolution ultrasonography during baseline,reactive hyperemia and sublingual nitroglycerin administration in sixty-eight patients with both hypertensive disease and cerebral infarction and forty-six healthy subjects. Reactive hyperemia-induced and nitroglycerin-induced percent changes in brachial artery diameter were calculated. Results The percent change in the brachial artery diameter induced by reactive hyperemia in the patients with both hypertensive disease and cerebral infarction was significantly less than that in healthy subjects. No significant difference could be found in percent change in the brachial artery diameter induced by sublingual nitroglycerin between the patients and the controls. Conclusion In elderly patients with both hypertensive disease and cerebral infarction, the endothelium-dependent vasodilation function is impaired. It is an accurate and noninvasive method to evaluate endothelial function of peripheral artery with high-resolution ultrasonography.