| Coronary heart disease is a kind of ischemia and anoxiadisease .Atherosclerosis is systemic disease .Endothelial function is thefirst step of Atherosclerosis,some investigation had indicated that arteryendothelia proliferation is a early feature,so artery endothelial functionplay a very important role in occur,develop and result of Atherosclerosis.There is abnormal of artery endothelial function before Atherosclerosisdeveloped.In this study we find that the impairment of the brachial ateryendothelial function by using high resolution ultrasound.The non-invasiveassessment of flow-mediated dilation and glyceryl trinitrate-mediateddilation in the brachial artery can be used as a kind of methods to measurecoronary endothelial function.Objective:To explore the endothelium-dependent and endothelium independe-nt vasodilator changes in CHD by ultrasonography.Method:In this investigation we monitored the 50 patients who came to thethird medical college of jilin university during 2005-2006. The patientswere divided into 2 groups, the one group were coronary heart diseasepatients, 30 cases in all, 16 cases were men, 14 cases were women, theywere 60 to 73 years old,the mean age was 68.5 years old.8 cases weremyocardial infarction patients,22 cases were angina pectoris patientswhose electrocardiogram have ischemic change,22 cases were verified bypercutaneous transluminal coronary angioplasty(PTCA) that coronaryartery stenosis exceed 50%and have not diabetes mellitus .The other groupis control group,20 cases,12 cases were men,8 cases were women,theywere 55-68 years old,the mean age was 58.3 years old and have notcoronary heart disease,diabetes mellitus,electrocardiograms werenormal.The two groups have no distinct difference in bloodpressure,sex,age,cholesterdemic,high density lipoprotein(P > 0.05)andhave significant difference in concentration of concentration oftriglyceride,low density lipoprotein cholesterol(P<0.05).All data wasdelivered through means value±standard errand( X ±S),we analyzed thetwo groups through t test and risk factors through multiple stepwiseregression analysis.Results(1)CHD patients brachial artery were twist, endomembrane becamethicker,control group brachial artery were straight and slick.(2)Coronary heart disease patients brachial artery diameter waswider than that of control group patients(P<0.05).(3)The coronary heart disease patients flow-mediated dilation(3.68±1.91%) and glyceryl trinitrate-mediated dilation(16.33±3.33%) weredecreased than that of the control group (6.33±3.59% vs 23.31±6.63%)(P<0.01).(4)By multiple stepwise regressions analysis, FMD in CHD wasinversely associated with TG, LDL-C, brachial artery diameter (r=-0.168,P<0.01;r=-0.126,P<0.01;r=-0.246,P<0.01). so brachial arterydiameter,FMD,NMD and plasma lipid are very significant to theprevent,diagnosis and therapy in CHD.In all,endothelial dysfunction happened earlier than Atherosclerosisanatomy change.The non-invasive assessment of endothelial function isvery important to the early diagnosis and therapy in CHD and reverse theimpairment of endothelial function. The examination of endothelialfunction was applied to different group that have differrent risk factors. Ina word, the examination of endothelial function in the past wasangiocardiography and intravascular Ultrasound, but they have manyshortage,such as confine,invasive and expensive, so the high-resolutionUltrasound accessment can be used as a kind of method to access coronaryendothelial function.
|
PDF Full Text Request