高脂蛋白血症患者动脉内皮非依赖性舒张功能的超声观测

目的利用高分辨力超声评价高脂血症(HLP，Hyperlipidemia)患者肱动脉内皮非依赖性舒张功能的变化。方法155名研究对象分为4组，I组为正常对照组，32例，Ⅱ组为高胆固醇症(HC)组，39例，Ⅲ组为高甘油三酯血症组(HTG)，33例，Ⅳ组为混合性高脂血症组(MHLP)51例，测量肱动脉内皮依赖性舒张功能(EDD)和内皮非依赖性舒张功能(ELD)，并观测Ⅱ、Ⅳ组含服硝酸甘油后血流动力学指数(VTI、PI)的变化。结果与正常对照组相比，HLP患者EDD与EID均明显受损〔EDD(10.3±3.2)％vs(5.7±3.1)％、(5.4±3.0)％、(3.3±3.4)％；EID(19.2±5.3)％vs(16.1±5.5)％、(13.6±4.9)％、(13.4±4.6)％〕。I、Ⅳ组含服硝酸甘油后其PI较基态明显升高(I组3.6±0.8vs9.4±2.4，P＜0.05，Ⅳ组3.7±1.2vs10.5±3.0，P＜0.05)，VTI较基态明显降低(I组0.10±0.07vs0.28±0.12，P＜0.05，Ⅳ组0.09±0.06vs，0.23±0.13，P＜0.05)。结论HCP患者EDD、EID较正常人明显受损。

Investigation of Endothelium-independent Vasodilation in Hyperlipidemic Subjects by High-resolution Ultrasound

To assess endothelial-independent vasodilation function in patients with hyperlipidemia by high-resolution ultrasound. Methods: One hundred and fifty five subjects were divided into 4 groups. Gruoup ?Ⅰ 、 Ⅱ 、 Ⅲ 、 Ⅳ were normal controls、 hypercholesterolemic、 hyperglyceridemic and mixed HLP subjects respectively.Endothelial-independent vasodllation(EID)and endothelial-dependent vasodilation(EDD)in brachial arteries were evaluated. PI、 VTI in group I and group Ⅳ were measured respectively at baseline and after sublingual nitroglycerin. Results: Compared to controls. HLP patients showed markedly impaired EID, EDD (EDD 10. 3±3.2% vs 5.7±3.1 %,5.4±3.0%, 3.3±3.4%,EID: 19.2±5.3% vs 16.1±5.5%, 13.6±4.9%, 13.4±4.6%). InGroup I andGroup Ⅳ , PI were increased significantly after sublingual nitroglycerin than those in baseline (group I 3.6±0. 8 vs 9.4±2.4, P＜0. 05, group Ⅳ 3.7± 1.2 vs 10.5± 3.0, P＜0. 05), VTI were reduced significantly after sublingual nitroglycerin than those in baseline (group I : 0. 10±0. 07 vs 0.28±0. 12, P＜0. 05, group Ⅳ: 0.09±0. 06 vs 0. 23±0.13,P＜0. 05). Conclusions: EID and EDD were impaired in HLP patients.