X综合征患者血管内分泌功能和内皮依赖性舒张功能障碍的研究

目的　研究内皮依赖性舒张功能障碍在X综合征患者发病中的意义。方法　对 18例X综合征患者和 2 0例正常对照者 ,采用高分辨多普勒超声仪测定肱动脉基础、反应性充血和舌下含服硝酸甘油后血管舒张末期内径变化 ,并测定血浆内皮素 (ET)、一氧化氮 (NO)含量。结果　 (1)X综合征患者肱动脉血流介导的血管扩张较对照组明显减弱 ,含服硝酸甘油后血管明显扩张 ,但两组无显著差异 ;(2 )X综合征组较对照组ET水平显著升高 ,NO水平显著降低 ;(3)肱动脉血流介导的血管扩张与血浆ET水平呈显著负相关 ,与NO水平呈显著正相关。结论　X综合征患者存在血管内分泌功能紊乱、内皮依赖性舒张功能障碍 ,后者与内皮源性松弛因子减少有关。

Dysfunction of endothelial secretion and endothelium-dependent relaxation in patients with X syndrome

Objectives To study the role of endothelial dysfunction in patients with syndrome X Methods High-resolution ultrasound was used to measure the change in diameter of the brachial artery before and after the reactive hyperemia and sublingual administration of nitroglycerin in 18 patients with syndrome X and 20 matched healthy subjects. The concentrations of plasma endothelin(ET) and nitric oxide(NO) were assayed in the two groups. Results (l) In patients with syndrome X, flow mediated dilation(FMD) in artery was much reduced as compared with that in the healthy subject. However, the response to nitroglycerin was similar in the two groups. (2)The level of NO was evidently decrease, while ET level was higher in study group than in control group. (3) FMD was negatively correlated with ET, while positively correlated with NO. Conclusions In patients with syndrome X , there were dysfunctions of endothelial secretion and endothelium-dependent relaxation. The latter was correlated with the decrease of endothelium-derived relaxing factors and the increase of contracting factors.