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无创研究

目的　探讨老年周围动脉闭塞性疾病 (peripheralarterialocclusivedisease,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 mediateddi lation,NMD)状况及其相关因素。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例健康老年人及 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 ;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 ;FMD与NMD呈正相关 ,肱动脉基础内径与NMD呈负相关。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。

Non-invasive investigation on vasodilation in peripheral arterial occlusive disease of the elderly

Objective To evaluate the endothelium-dependent(i.e. flow-mediated dilation,FMD)and endothelium-independent vasodilation(i.e.nitroglycerin-mediated dilation,NMD) in peripheral arterial occlusive disease (PAOD) of the elderly and to investigate the factors associated with FMD and NMD respectively.Methods Both FMD and NMD of the brachial artery in 33 old PAOD patients were examined by the color Doppler ultrasonograph and compared with 40 old healthy controls and 30 old non-PAOD patients with cardiovascular risk factors respectively.Results Both FMD and NMD of the brachial artery in 33 old PAOD patients were significantly weaker than those in 40 old healthy controls and 30 old non-PAOD patients with cardiovascular risk factors.The basic diameter of brachial artery,systolic blood pressure and the concentration of LDL-C correlated negatively with brachial FMD.FMD correlated positively with NMD,while the basic diameter of brachial artery had negative correlation with NMD.Conclusions Both FMD and NMD of the old PAOD patients are impaired.The basic vascular diameter,systolic blood pressure and the concentration of LDL-C may be the independent predictors of brachial FMD.