老年周围动脉闭塞性疾病内皮和非内皮依赖性舒张功能的分析(英文)

Non-invasive investigation on endothelium-dependent and endothelium-independent dilation of peripheral arterial occlusive di sease in the elderly

目的通过探讨老年周围动脉闭塞性疾病(peripheralarterialoc-clusivedisease,PAOD)内皮依赖性舒张功能,即血流介导的血管扩张功能(flow-mediateddilation,FMD)和硝酸甘油介导的非内皮依赖性舒张功能(nitroglycerin-mediateddilation,NMD)状况,了解其相关因素。方法采用超声多普勒检测33例已确诊为PAOD的老年患者肱动脉FMD及NMD,并分别与40例健康老人及30例具有心血管危险因素的老年非PAOD患者进行对照研究。结果老年PAOD患者FMD及NMD均显著低于对照组(t=-2.2358～2.7317,P<0.01),;肱动脉基础内径、收缩压、低密度脂蛋白胆固醇与FMD呈负相关(相关系数r分别为-0.632,-0.479,-0.608,P值分别为0.0001,0.02,0.001);FMD与NMD呈正相关(r=0.364,P=0.004),肱动脉基础内径与NMD呈负相关(r=-0.391,P=0.0006)。结论老年PAOD患者FMD及NMD均受损;肱动脉基础内径、收缩压、低密度脂蛋白胆固醇可能是FMD独立的预测因子;而FMD及肱动脉基础内径与NMD密切相关。

Aim To evaluate the endothelium-dependent dilation(i.e.flow-mediated dila tion,FMD)and endothelium-independent dilation(i.e.nitroglycerin-mediated dilat ion,NMD)of peripheral arterial occlusive disease(PAOD)in the elderly a nd to investigate the relative factors associated with FMD and NMD respectively .Methods Both FMD and NMD of the brachial artery in 33old PAOD patien ts wer e detected by the color Doppler ultrasonograph and compared with 40old healthl y controls and 30old non-PAOD patients with cardiovascu lar risk factors resp ectively.Results①Both FMD and NMD of the brachial artery in 33old PAOD patie nts were less than those of 40old healthly control s and 30old non-PAOD pat ients with cardiovascular risk factors signif icantly(t=-2.2358-2.7 317,P<0.01).②The basic vascular diameter,systolic blood pressure an d the blood con-centration of LDL-C related with bra chial FMD negatively .③ FMD related with NMD positively,but the basic va scular diameter had negative r elation-ship with NMD.Conclusion Both FMD and NMD of the old PAOD patien ts we re impaired .The basic vascular di ameter,systolic blood pressure and the conc entration of LDL-C may be independent predictors of brachial FMD.