高频超声评价急性心肌梗死患者肱动脉内皮功能

目的应用高频超声检测急性心肌梗死（AMI）患者反应性充血前后肱动脉内径扩张百分率评价肱动脉内皮功能。方法对27例病程6周的AMI患者（根据超声心动图分为重构组和非重构组）和20例正常人应用高频超声测量静息状态、反应性充血后及舌下含硝酸甘油后肱动脉内径，计算反应性充血和硝酸甘油诱发的肱动脉内径扩张百分率。结果重构组和非重构组反应性充血诱发的肱动脉内径扩张百分率均低于对照组（P〈0．01）；重构组反应性充血诱发的肱动脉内径扩张百分率低于非重构组（P〈0．05）；重构组和非重构组间及两组与对照组间含硝酸甘油后的肱动脉内径扩张百分率均无差异（P〉0．05）。结论AMI患者肱动脉内皮依赖性舒张功能减低，AMI后早期左室重构与内皮功能障碍有关。

Evaluation of Brachial Artery Endothelial Function in Patients with Acute Myocardial Infarction Using High Resolution Ultrasonography

Objective To evaluate brachial artery endothelial function in patients with acute myocardial infarction (AMI)using the percent age change in the brachial artery diameter induced by reactive hyperemia was detected with high resolution ultrasonography.Methods Twenty-seven patients with 6 week AMI(remodeling group and non-remodeling group on echocardiography)and twenty healthy subjects were studied.Brachial artery diameters were measured on high resolution ultrasonography during baseline,reactive hyperemia and sublingual nitroglycerin administration.Percent-age changes in the brachial artery diameter induced by reactive hyperemia were calculated and compared.Results The percentage changes induced by reactive hyperemia in patients with remodeling group and non-remodeling group were significantly lower than those in the healthy subjects(P<0.01).Further more,the percentage changes in the brachial artery diameter induced by reactive hyperemia in patients with remodeling group were significantly less than those in non-remodeling group(P<0.05);whereas nitroglycerin induced diameter change was similar in all patients of remodeling group,non-remodeling group and healthy subjects(P>0.05). Conclusions Vascular endothelial dependent diastolic function was decreased significantly in AMI patients and the early post-infarted ventricular remodeling was associated with endothelial dysfunction.