X综合征患者内皮素-1及血管内皮依赖性舒张功能的变化

The Changes of the Endothelin-1 and Endothelium Dependent Vasodilatation Function in the Patients with Syndrome X

目的 :观察 X综合征患者内皮素 - 1( ET- 1)及血管内皮依赖性舒张功能变化。 方法 :采用高分辨超声技术检测 15例 X综合征患者 ( X综合征组 )血管内皮依赖性舒张功能 ,并测定其血中 ET- 1含量 ,与 2 0例正常人 (正常对照组 )进行对照。 结果 :1X综合征组患者反应性充血引起的肱动脉内径变化较正常对照组明显减弱 [( 4 .2± 2 .1) %比 ( 13 .6±3 .2 ) % ,P<0 .0 0 1],而两组患者对硝酸甘油的反应无显著性差异 [( 2 1.6± 7.8) %比 ( 2 2 .8± 4 .7) % ,P>0 .0 5 ]。 2 X综合征组患者在胸痛前、胸痛发作时及胸痛后的 ET- 1含量均较正常对照组明显升高 ( 6.74± 2 .4 1ng/ L ,10 .0 7± 1.93 ng/L及 7.4 2± 2 .2 4 ng/ L比 4 .13± 1.3 6ng/ L ,P<0 .0 1)。胸痛发作时 ET- 1含量较胸痛前及胸痛后亦有明显差异 ( P<0 .0 1)。 3肱动脉内皮依赖性舒张功能变化与 ET- 1含量呈显著的负相关 ( r=- 0 .73 2 8,P<0 .0 0 1)。 结论 :X综合征患者存在明显的血管内皮依赖性舒张功能障碍 ,心绞痛发作和 ET- 1水平增高有关。提示内皮功能异常在 X综合征患者的发病过程中起重要作用。

Objective:To observe the changes of the endothelin 1(ET 1) and endothelium dependent vasodilatation function in the patients with syndrome X. Methods:With high resolution ultrasound,endothelium dependent vasodilatation function was measured in 15 patients with syndrome X and 20 healthy peoples.The concentration of plasma ET 1 was also assayed in two groups. Results:①In patients with syndrome X,flow mediation dilation in artery was much reduced comparied with healthy peoples[(4 2±2 1)% vs.(13 6±3 2)%, p <0 001].However,there was no significant difference in response to nitroglycerin between two groups [(21 6±7 8)% vs.(22 8±4 7)%, p >0 05].②The levels of plasma ET 1 in syndrome X were much increased comparied with that in healthy peoples(6 74±2 41 ng/L vs.4 13±1 36 ng/L, p <0 01).The ET 1 values at the attack of angina were significantly higher than those before and after angina( p <0 01).③The changes of endothelium dependent relaxing function in artery were negatively correlated to plasma ET 1 values( r =-0 7328, p <0 001). Conclusion:In the patients with syndrome X,there was endothelium dependent vasodilatation dysfunction,the attack of angina was related closely to the marked increase of the plasma ET 1 values.