超声测定脑梗死患者血管舒张功能

目的 研究脑梗死患者肢体瘫痪是否会影响肱动脉血流介导的舒张功能(brachial artery-flow mediated dilation, BA-FMD)和硝酸甘油介导的舒张功能(nitroglycerin mediated dilation, BA-NMD),以及能否测量含服硝酸甘油后颈内动脉的扩张更直接地反映脑梗死患者病变血管的舒张功能.方法 应用高分辨率超声分别对13例急性期脑梗死患者在静息时、反应性充血时和含服硝酸甘油后双侧肱动脉内径变化,另有13例患者同时测量颈总动脉(common carotid artery, CCA)内径变化,其中8例患者同时测定颈内动脉(internal carotid artery, ICA)内径变化.结果 脑梗死患者双侧肱动脉血流介导的扩张和硝酸甘油介导的扩张无显著差异,CCA-NMD与BA-NMD无明确相关性(r=0.52, P=0.07),ICA-NMD与BA-NMD呈正相关(r=0.83, P=0.01).结论 脑梗死患者急性期双侧肱动脉血流介导的扩张和硝酸甘油介导的扩张无显著差异.测量颈内动脉硝酸甘油介导的扩张可以更直接地反映脑梗死患者病变血管的舒张功能.

Ultrasonic measurement of vasodilation in cerebral infarction patients

Objective To investigate the bilateral flow-mediated dilation of brachial artery (BA-FMD) and nitroglycerin mediated dilation (BA-NMD) in patients with cerebral infarct, and to find out if the vasodilation of internal catotid artery after sublingual administration of nitroglycerin can be detected as a more direct way to reflect the vasodilation in patients with cerebral vascular diseases. Methods High resolution ultrasonic system was used to measure 13 patients with acute cerebral infarction. The diameter of brachial artery, internal carotid artery and common carotid artery was measured at relaxation, reactive congestion in the brachial artery and after sublingual administration of nitroglycerin. Meanwhile, the intima media thickness (IMT) and plaques of carotid artery was detected. Results Paralysis did not lead to differences in vasodilation of brachial artery (r=0.52, P=0.07). There was a correlation between ICA-NMD and BA-NMD (r=0.83, P=0.01). Conclusion There were no significant differences between brachial vasodilation in paretic and non-paretic limbs of patients with acute cerebral infarction. Ultrasonic measurement of ICA-NMD can be a more direct measure of the vasodilation of patients with cerebral infarction.