老年冠心病患者血管内皮功能与动脉粥样硬化的关系

Relationship of vascular endothelial function and atherosclerosis in elderly patients with coronary artery disease

目的观察老年冠心病（CAD）患者血管内皮舒张功能、动脉硬化的状况及与冠状动脉病变的相关性。方法选择经冠状动脉造影确诊为CAD的患者90例（CAD组），冠状动脉造影证实无冠状动脉狭窄并无其他疾病史的患者30例为对照组，采用二维超声检测肱动脉内皮依赖性和非依赖性舒张功能及动脉内膜的变化，应用二维彩色多普勒超声检查颈动脉、股动脉，观察管腔、管径、内膜及有无斑块、血流变化、血流频谱形态及性质。动脉粥样硬化斑块积分采用Grouse法。对血管内皮细胞功能、动脉硬化与冠状动脉病变程度进行分析。结果反应性充血引起的肱动脉内径变化在单支组及多支组明显减弱[（9．08±2．28）％、（6．14±2．21）％]，与对照组[（15．58±2．20）％]比较，差异有统计学意义（P〈0．01）。CAD组颈动脉内膜中层厚度（IMT）高于对照组（P〈0．05）。结论内皮细胞功能障碍和动脉粥样硬化与冠状动脉粥样硬化的病变密切相关。

Objective To investigate the endothelial function and atherosclerosis in patients with coronary artery disease （CAD）. Methods Two-dimensional echocardiography （2 DE） was used to measure changes in brachial artery inner diameter as parameter of endothelium-dependant and endothelium-nondependant vascular diastolic function and pathologic characters of carotid atherosclerosis in 90 elderly CAD patients and 30 controls. Results Endothelium dependant vascular diastolic function and endothelium-non dependant diastolic function were significantly decreased in CAD group as compared with control group [（9.08± 2.28） % and （ 6.14 ± 2.21 ）% vs. （15.58±2.20） %, P〈0.01]. The carotid intima-media thickness and plaque score were significantly increased in CAD group as compared with control group. Conclusions There are correlations of endothelium dysfunction and carotid atherosclerosis are relatied to with coronary atherosclerosis.