早期冠心病患者颈动脉弹性及肱动脉内皮功能相关性的超声评价

目的:研究肱动脉内皮依赖性舒张功能变化与早期冠心病患者颈动脉弹性相关关系,以探讨多谱勒超声在早期定量判断冠心病患者动脉血管功能的临床应用价值。方法:应用高分辨率超声及E-Tracking技术测定200例冠心病患者肱动脉内皮依赖性舒张功能(FMD)和颈动脉硬化参数,同时测定200例健康自愿者肱动脉内皮依赖性舒张功能(FMD)和颈动脉硬化参数,对比分析两组患者肱动脉FMD及颈动脉硬化参数的差异,并分析压力应变弹性系数(Eρ)、硬化度(β)、顺应性(AC)与FMD的相关性。结果:冠心病组肱动脉FMD及颈动脉硬化参数与志愿组差异明显(P<0.05);肱动脉FMD与Eρ、β呈负相关(相关系数r=-0.78,P<0.01;r=-0.83,P<0.01),肱动脉FMD与AC呈正相关(r=0.71,P<0.01)。结论:肱动脉内皮依赖性舒张功能变化与颈动脉硬化参数高度相关;通过多谱勒超声测量颈动脉硬化参数能较好的反映肱动脉内皮依赖性舒张功能;多谱勒超声可作为冠心病患者动脉血管功能异常早期、定量、无创及简便的检查方法。

Ultrasound evaluation of correlation between carotid artery elasticity and brachial artery endothelial function in patients with coronary heart disease

Objective: To investigate the correlation between carotid artery elasticity and brachial artery endothelial function in patients with coronary heart disease(CAD),and to explore the application value of ultrasound in detecting arterial blood vessel function in CAD patients.Methods: Evaluation of Flow-mediated dilation(FMD) in the brachial artery was performed in 200 patients with CAD and 200 healthy volunteers with E-tracking technique.FMD and carotid atherosclerosis parameters were compared between the two groups.Correlation between the pressure-strain elastic modulus(Eρ),stiffness parameter(β) and arterial compliance(AC) were anzlyzed.Results: CAD,FMD,Eρ and β were significant different in patients with CAD from that in healthy volunteers(P<0.05).FMD correlated negatively with Eρ and β(r=-0.78,P<0.01;r=-0.83,P<0.01)but correlated positively with AC(r=0.71,P<0.01).Conclusions: Impaired endothelium-dependent vasodilation and reduced arterial clasticitv were closely correlated with each other in the patients with CAD.Carotid atherosclerosis parameters can be used as indicators for evaluating arterial endothelial function,ultrasound is a non-invasive,quantitative,early,simple,examination method for detecting abnormal artery blood vessel function in patients with CAD.