高频超声检测肱动脉内皮功能的临床应用

Clinical application of high-resolution ultrasound detection of brachial artery endothelial function

目的利用高频超声并采用间歇成像探讨交叉因素对血管内皮依赖性与非依赖性舒张功能的影响。方法选择17例高血压病患者(1组)、17例高血压合并糖尿病患者(2组)与17例健康人(3组),测量静息时、反应性充血后及舌下含服硝酸甘油后肱动脉内径的变化,并计算比较3组的内径变化率。结果静息状态下,3组间肱动脉内径差异无显著意义;肱动脉反应性充血后引起的内径变化百分率为2组(7.58±1.34)%<1组(9.70±1.33)%<3组(12.58±1.47)%(P<0.05);1组、2组与3组比较差异有非常显著意义(P<0.01),且1组与2组间比较差异亦有显著意义(P<0.05);含服硝酸甘油后,3组间肱动脉内径比较差异均无显著意义(P>0.05)。结论高血压时已存在内皮依赖性血管舒张功能损伤,合并糖尿病后损伤更为严重。超声检查可为临床提供足够的内皮细胞功能受限的有力证据,可准确评价肱动脉内皮功能。

Objective Using inter image of high-resolution ultrasound to investigate the effect of intersect factors on the vascular endothelium-dependent and independent dilatation function. Methods The trial was divided into 3 groups, hypertension group consisted of 17 patients with mild-moderate essentialhypertension, hypertension complication group consisted of 17 patients with hypertension and type 2 diabetes mellitus, and 17 healthy subjects served as control group. The diameter of brachial artery was measured by high-resolution uhrasound at resting state, after reaction hyperemic condition and after sublingual nitroglycerin. Results There was no significant difference in diameter of brachial artery at resting state among the three groups. After reactive congestion of brachial artery the percentage of diameter change of brachial artery was （7.58 ± 1.34） % in hypertension complication group, （9.70 ± 1.33） % in hypertension group and （12.58 ± 1.47）% in control group, there were significant differences among the 3 groups （ P 〈 0.05 or P 〈 0.01） .After treatment with nitroglycerin, there were no significant differences in diameter of brachial artery among the 3 groups （ P 〉 0.05）. Conclusion The endothellum-dependent vasodilatation function in essential hypertension patients is decreased, which will become more serious in patients with essential hypertension combined with type 2 diabetes mellitus. Ultrasound detection as a convenient and accurate examination method could provide powerful proofs for clinic in endothelial function, and which could evaluate the bronchial artery endothelial function accurately.