颈动脉粥样硬化对血管储备能力的影响

The effects of aytherosclerosis on vascular reserve

目的研究动脉粥样硬化与颈部血管和周围血管肱动脉舒张能力的关系。方法选择自2005.04～2006.12以缺血性脑血管事件入院的病人117例,另外选择以非血管事件入院的病人100例作为对照组,纪录病人的详细既往史,测定血糖、血脂、肾功。多功能超声检测粥样斑块,累加斑块厚度作为该病人动脉粥样硬化的程度;分别测量每位受试者休息时、反应性充血后、含服硝酸甘油后右肱动脉内径及收缩期峰血流速度,测定右颈总动脉休息时和含服硝酸甘油后内径及收缩期峰血流速度。血管舒张能力根据公式(D1-D0)/D0×100%,(D2-D0)/D0×100%,用SSPS-11做直线相关性分析。结果病例组高血压病史、尿素氮、肌苷、血糖明显高于对照组,病例组的斑块累计厚度较对照组明显大;病例组有斑块者的比例明显大于对照组;以缺血性脑血管事件收住院的病人周围血管肱动脉和颈总动脉舒张能力低于对照组;颈动脉粥样硬化程度同颈部血管和周围血管的舒张能力成负相关,并且与颈部血管的舒张能力关系更大些。结论病例组动脉粥样硬化程度和发生率高于对照组,动脉粥样硬化程度与血管的舒张能力成负相关。

Objective To explore the relationship of atherosclerosis and carotid and brachial artery vasodilatory capacity. Methods 117 patients of cerebral ischemie invents and another 100 cases admitted for other neurological diseases from 2005.04-2006.12 were registered. Medical history were recorded and the fast glucose , lipids, creatine and urine nitrogen were measured. All patients were measured the carotid atherosclerotie severity.The inner diameter of right brachial artery at rest, after reactive hyperemia （endothelium-dependent dilation ） and after sublingual nitroglycerin （endothelium-independent dilation ） was measured. The right carotid artery were measured the ability of endothelium-independent dilation. Results The patients suffered cerebral ischemic event showed higher prevalence in hypertension history, highter values of blood pressure, fast blood glucose, creatine, nitrogen, lower values of high-density cholesterol, the grade of plaques of carotid artery adding up in the ischemic patients and the carotid atheroslerosisprevalent are higher compared with controls. The atheroslerosis of carotid is reversely correlated with the carotid and brachial artery′s reactivity induced by hyperemia and/or nitroglycerin. Conclusion The patients have more serious carotid atherosclerosis. The carotid atherosclersis is correlated negatively with the vascular reserve.