血管内皮功能的评价及其临床价值

Evaluation of Vascular Endothelial Function and Its Clinical Value

内皮功能障碍是动脉粥样硬化的始动环节,并参与动脉粥样硬化的进展,还可增加心脑血管疾病风险导致心血管事件,并且相对于传统的危险因素,其对于未来心血管事件具有附加的预测价值。此外,内皮功能参与动脉粥样硬化的各个阶段,从起始到动脉粥样硬化血栓形成的并发症都起关键作用,并且在各个阶段都具有可逆性,内皮功能检查可揭示动脉粥样硬化的最早改变之一,其指导的治疗在心血管疾病的临床实践中有效可行,将内皮功能检查引入临床实践能够创新个体化心血管医疗。因此,应用确定有效的方法来评估内皮功能以监测血管健康及评估预后疗效具有重要的临床意义。目前许多方法用于评估内皮功能障碍的程度,应用药理学和/或生理刺激一氧化氮和其他来自于血管内皮细胞的血管活性物质的释放,包括有创性的检查比如冠状动脉内注入乙酰胆碱、无创性的检查比如血流介导的血管舒张功能和外周动脉张力检测以及生物标志物检查。

Endothelial dysfunction plays a key role in the pathogenesis of atherosclerosis,and participate in the progress of atherosclerosis. It can also increase the risk of cardiovascular and cerebrovascular diseases and lead to cardiovascular events,and compared with the traditional risk factors,it has additional predictive value for future cardiovascular events. In addition,endothelial function participates in all stages of atherosclerosis,from the beginning to the complications,and in each stage it is reversible. Endothelial function tests can reveal one of the earliest changes in atherosclerosis,and the introduction of endothelial function examination into clinical practice can break new ground of the individual cardiovascular medicine. At present,many methods are used to evaluate the extent of endothelial dysfunction,including the invasive examination,such as the injection of acetylcholine and noninvasive tests such as blood flow mediated dilation and peripheral arterial tonometry examination and biological markers tests.