冠心病患者肱动脉内皮和非内皮依赖性舒张机能的变化

采用高分辨力超声法测定 6 6例冠心病患者和 33例对照者在反应性充血时和含服硝酸甘油后的肱动脉内径变化。结果显示 :冠心病组血流介导的和硝酸甘油所致的肱动脉舒张反应均明显低于对照组 (均为 P <0 .0 5 ) ;血流介导的肱动脉舒张反应与高密度脂蛋白胆固醇呈正相关 ,与肱动脉基础内径、年龄和低密度脂蛋白胆固醇呈负相关 ;而硝酸甘油所致的肱动脉舒张反应则与血流介导的肱动脉舒张反应呈正相关 ,与肱动脉基础内径呈负相关。提示冠心病患者内皮依赖性和非内皮依赖性血管舒张机能均受损

Changes of endothelium-dependent and endothelium-independent dilatation of brachial arteries in patients with coronary heart disease

By using high resolution ultrasound, the dilatation changes of brachial arteries during reactive hyperemia and after sublingual administration of glyceryl trinitrate(GTN) were measured in 99 subjects, consisted of 33 controls and 66 patients with established coronary heart disease. The results showed that both flow mediated dilatation(FMD) and GTN induced dilatation of brachial arteries in patients with coronary heart disease were significantly reduced as compared with those in control group(2.44%±2.94% vs 8.17%±4.80% and 16.58%±6.26% vs 23.12%±8.88%, respectively, P<0.01 for all). Multiple linear stepwise regression analysis showed that FMD was positively related to highdensity lipoprotein cholesterol and inversely related to baseline diameters of brachial arteries, age and lowdensity lipoprotein cholesterol, whereas GTN induced dilatation was positively related to FMD and inversely related to baseline diameters of brachial arteries. The present study suggests that both endotheliumdependent and endotheliumindependent vasodilatation are impaired in patients with coronary heart disease.