超声检测非酒精性脂肪肝病患者肱动脉内皮功能

目的:评价非酒精性脂肪性肝病患者的肱动脉内皮功能。方法:选取50例非酒精性脂肪性肝病患者和40例健康对照者,应用高频超声测量静息状态下、反应性充血后、舌下含服硝酸甘油后的肱动脉内径,并计算反应性充血和硝酸甘油诱发的内径百分变化率。检测血胰岛素抵抗(IR-HOMA)并进行统计学分析。结果:非酒精性脂肪性肝病组反应性充血诱发的肱动脉内径百分变化率显著低于对照组(P<0.001),而两组对硝酸甘油的反应差异无显著性意义(P>0.05);内皮依赖性舒张功能(D1%)与IR-HOMA呈负相关(r=-0.243,P=0.030)。结论:非酒精性脂肪性肝病患者早期即存在血管内皮依赖性舒张功能障碍。

Evaluation of brachial artery endothelial function in patients with nonalcoholic fatty liver disease by ultrasonography

Objective:To evaluate brachial artery endothelial function in patients with nonalcoholic fatty liver disease(NAFLD) by high resolution ultrasonography.Methods:Measurements of brachial artery diameter were performed by high resolution ultrasonography during baseline,reactive hyperemia and sublingual nitroglycerin administration in 50 patients with nonalcoholic fatty liver disease and 40 healthy subjects.The changes in brachial artery diameter induced by reactive hyperemia and induced by nitroglycerin were calculated.Insulin resistant calculated with homeostasis model assessment(HOMA) method statistics was used.Results:The percent change in the brachial artery diameter induced by reactive hyperemia in patients with NAFLD was significantly less than that in healthy subjects(P<0.001),whereas nitroglycerin-induced changes were similar(P>0.05).The changes in the brachial artery diameter induced by reactive hyperemia(D_1%) in patients with NAFLD was negatively associated with IR(r=-0.243,P=0.030).Conclusion:Endothelium-dependent vasodilation function was impaired early in patients with NAFLD.