Long-term ascorbic acid administration reverses endothelial vasomotor dysfunction in patients with coronary artery disease
Long-term ascorbic acid administration reverses endothelial vasomotor dysfunction in patients with coronary artery disease
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DOI：
10.1161/01.cir.99.25.3234
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发表时间：
1999-06-29
期刊：
影响因子：
37.8
通讯作者：
Vita, JA
中科院分区：
文献类型：
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作者：
Gokce, N;Keaney, JF;Vita, JA
背景-内皮源性一氧化氮(EDNO)的缺失与冠心病(CAD)的临床表现有关。在动脉粥样硬化中，氧化应激增加与内皮血管运动功能受损有关，最近的研究表明，短期抗坏血酸治疗可改善内皮功能。方法和结果：在一项随机、双盲、安慰剂对照研究中，我们研究了单剂量(2g PO)和长期(500 mg/d)抗坏血酸治疗对血管造影术确诊的冠心病患者的EDNO依赖的血流介导的肱动脉扩张的影响。应用高分辨率血管超声对46例冠心病患者在基线、单次给药后2小时和长期治疗30天后进行血流介导的血管扩张检测。单次给药后血流介导的扩张率从6.6+/-3.5%提高到10.1+/-5.2%，长期治疗后持续有效(9.0+/-3.7%)，而血流介导的扩张在基线时为8.6+/-4.7%，在单剂(7.8+/-4.4%)和长期(7.9+/-4.5%)安慰剂治疗后保持不变(重复测量方差分析，P=0.005)。血浆抗坏血酸浓度单次给药后由41.4+/-12.9升至115.9+/-34.2mU/L，长期用药后升至95.0+/-36.1mU/L(P
Background-Loss of endothelium-derived nitric oxide (EDNO) contributes to the clinical expression of coronary artery disease (CAD). Increased oxidative stress has been linked to impaired endothelial vasomotor function in atherosclerosis, and recent studies demonstrated that short-term ascorbic acid treatment improves endothelial function.Methods and Results-In a randomized, double-blind, placebo-controlled study, we examined the effects of single-dose (2 g PO) and long-term (500 mg/d) ascorbic acid treatment on EDNO-dependent flow-mediated dilation of the brachial artery in patients with angiographically established CAD. Flow-mediated dilation was examined by high-resolution vascular ultrasound at baseline, 2 hours after the single dose, and 30 days after long-term treatment in 46 patients with CAD. Flow-mediated dilation improved from 6.6+/-3.5% to 10.1+/-5.2% after single-dose treatment, and the effect was sustained after long-term treatment (9.0+/-3.7%), whereas flow-mediated dilation was 8.6+/-4.7% at baseline and remained unchanged after single-dose (7.8+/-4.4%) and long-term (7.9+/-4.5%) treatment with placebo (P=0.005 by repeated-measures ANOVA). Plasma ascorbic acid concentrations increased from 41.4+/-12.9 to 115.9+/-34.2 mu mol/L after single-dose treatment and to 95.0+/-36.1 mu mol/L after long-term treatment (P