CAJ | 학술논문

观察高脂血症冠心病患者内皮依赖性血管舒张功能，探讨其临床意义。选择混合高脂血症患者20例、冠心病患者30例(按病变程度分为冠心病Ⅰ组和Ⅱ组)和对照组20例，按照Celermajer设计的方法,用高分辨超声测定右肱动脉内皮依赖性舒张功能。结果发现反应性充血右肱动脉扩张变化百分数高脂组、冠心病Ⅰ组和Ⅱ组比对照组明显下降（P<0.05、P<0.01、P<0.01)；冠心病Ⅰ组、Ⅱ组比高脂组明显下降（P<0.05、P<0.01）；冠心病Ⅱ组比Ⅰ组降低（P<0.01）。含服硝酸甘油后四组动脉内径均有不同程度扩张，但冠心病Ⅰ组、Ⅱ组比对照组、高脂组动脉扩张明显减少（均P<0.01）；冠心病Ⅰ组、Ⅱ组间无明显差异；对照组、高脂组间也无明显差异。以上提示，随着动脉粥样硬化的逐渐发展加重，内皮依赖性血管舒张功能逐渐降低；肱动脉的内皮依赖性血管舒张功能与冠状动脉及外周动脉粥样硬化的严重程度相关联；该高分辨超声测定血管内皮舒张功能的方法可靠、易行。
관찰고지혈증관심병환자내피의뢰성혈관서장공능，탐토기림상의의。선택혼합고지혈증환자20례、관심병환자30례(안병변정도분위관심병Ⅰ조화Ⅱ조)화대조조20례，안조Celermajer설계적방법,용고분변초성측정우굉동맥내피의뢰성서장공능。결과발현반응성충혈우굉동맥확장변화백분수고지조、관심병Ⅰ조화Ⅱ조비대조조명현하강（P<0.05、P<0.01、P<0.01)；관심병Ⅰ조、Ⅱ조비고지조명현하강（P<0.05、P<0.01）；관심병Ⅱ조비Ⅰ조강저（P<0.01）。함복초산감유후사조동맥내경균유불동정도확장，단관심병Ⅰ조、Ⅱ조비대조조、고지조동맥확장명현감소（균P<0.01）；관심병Ⅰ조、Ⅱ조간무명현차이；대조조、고지조간야무명현차이。이상제시，수착동맥죽양경화적축점발전가중，내피의뢰성혈관서장공능축점강저；굉동맥적내피의뢰성혈관서장공능여관상동맥급외주동맥죽양경화적엄중정도상관련；해고분변초성측정혈관내피서장공능적방법가고、역행。
Aim　To observe endothelium-dependent relaxing function of the patients with hyperlipidemia and coronary heart disease (CHD) and explore their clinical significance.　Methods　20 cases with hyperlipidemia, thirty cases with CHD confirmed by coronary angiography were classified as two groups, CHD group Ⅰ with 17 cases, and CHD group Ⅱ with 13 cases.　20 healthy individuals are as control group.　Brachial endothelium-dependent relaxing function was detected with high-resolusion ultrasound.　Results　Basic diameters of brachial arteries in four groups had no differences.　Flow- mediated dilatations of brachial arteries in the group of hyperlipidemia, CHD group Ⅰ, CHD group Ⅱ were significantly reduced compared with control group (P<0.05, P<0.01, P<0.01).　CHD group Ⅰ, CHD group Ⅱ were significantly droped compared with the hyperlipidemia (P<0.05, P<0.01).　There was also significant difference between CHD Ⅰ and Ⅱ groups (P<0.01).　After being sucked nitroglycerin the diameters of brachial arteries in four groups were all variously dilated.　But CHD groups were signifficontly reduced compared with control group and group of hyperlipidemia(P<0.01,P<0.01).　There was no significant change between CHD Ⅰ and CHD Ⅱ.　There was no significant change between control group and group of hyperlipidemia.　Conclusions　Endothelium-dependent relaxing function was gradually reduced with the severity of atherosclerosis.　It was confirmed that there is a relation between endothelium- dependent relaxing function by high -resolusion ultrasound and severity of atherosclerosis in coronary arteries and peripheral arteries.