摘要
【目的】通过对慢性心力衰竭(CHF)病人血浆血管性血友病因子(vWF)和血流介导性肱动脉内皮舒张功能(FMD)的测定,探讨心衰病人vWF和FMD的变化及其与心力衰竭的关系。【方法】随机选择冠心病心衰患者35例,冠心病无心衰患者15例,扩张型心肌病心衰患者16例,健康人18例。采用SONOS5500型超声心动图仪检测肱动脉基础状态下、反应性充血时(内皮依赖性舒张)及含服硝酸甘油后(非内皮依赖性舒张)的内径。计算反应性充血时肱动脉内径舒张百分比及含服硝酸甘油后肱动脉内径舒张百分比。同日抽取静脉血,采用酶联免疫吸附双抗体夹心法定量测定血浆vWF含量。【结果】①与正常组比较,冠心病心衰组及无心衰组、扩心病心衰组FMD均显著降低(P<0.05)。其中,冠心病心衰组FMD显著低于冠心病无心衰组及扩心病心衰组(P<0.05)。与正常组比较,冠心病心衰组及无心衰组、扩心病心衰组vWF均显著增高(P<0.05)。其中,冠心病心衰组vWF显著高于冠心病无心衰组及扩心病心衰组(P<0.05)。②冠心病心功能越差,FMD降低及vWF增高越明显。直线相关分析表明,血浆vWF与左室射血分数(LVEF)呈负相关(r=-0.426,P<0.002)。肱动脉FMD与LVEF呈正相关(r=0.353,P<0.05)。【结论】①慢性心衰患者存在内皮功能障碍。②冠心病心衰内皮功能损害程度与心衰严重程度有一定的相关性。
[Objective]To investigate the characteristics of plasma von willebrand factor （vWF） and flow-mediated dilation （FMD） of the brachial artery in patients with chronic heart failure（CHF）. [Methods]Thirtyfive patients with coronary heart disease accompanied with CHF, fifteen patients with coronary heart disease without CHF, sixteen patients with dilated cardiemyopathy accompanied with CHF, and eighteen healthy controls were enrolled in this study. The inner diameter of the brachial artery was measured by B-mode ultrasound at rest, during reactive hyperaemic flow and after sublingual nitroglycerin, The dilatation percentage of inner diameter of the brachial artery at FMD and Nitroglycerin-mediated dilation were calculated respectively, The plasma vWF was determined by ELISA. [Results]①The flow-mediated dilation in all patients of coronary heart disease accompanying with or without CHF, and of the dilated cardiomyopathy was significantly lower than that in the control （ P〈0.05）, The flow-mediated dilation in the patients of coronary heart disease with CHF was significantly lower than that in the patients of coronary heart disease without heart failure and in the patients of dilated cardiomyopathy （ P 〈0. 05）. As compared to the control, the plasma vWF increased significantly in all the groups of the dilated cardiomyopathy, of the coronary heart disease with CHF and without CHF （ P〈0.05）, The plasma vWF in the patients of coronary heart disease with CHF was significantly higher than that without CHF and the dilated cardiomyopathy （ P〈0.05. ） ② The worse the cardiac function was in patients of coronary heart disease with CHF, the lower the flow-mediated dilation was and the higher the vWF was respectively. The level of plasma vWF was negatively related to left ventricle ejection fraction（LVEF） （ r =-0. 426, P〈0. 002）in patients with CHF, Flow-mediated dilation was positively related to LVEF （ r =0. 353, P〈0. 05） in patients with CHF. [Conclusion]①Endothelial dysfu
出处
《医学临床研究》
CAS
2006年第10期1545-1548,共4页
Journal of Clinical Research
关键词
心力衰竭
充血性
慢性病
内皮
血管
heart failure, congestive
chronic disease
endothelium, vascular
