Vascular endothelial dysfunction associated with severity in multiple sclerosis
Vascular endothelial dysfunction associated with severity in multiple sclerosis
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血管内皮功能障碍与多发性硬化症的严重程度相关
DOI：
10.1016/j.msard.2021.103135
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Kensuke Senzaki
中科院分区：
文献类型：
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作者：
Kensuke Senzaki
背景多发性硬化（MS）患者脑血管反应性（CVR）受损已被报道。慢性炎症和内皮功能障碍是这种血流动力学损害的可能机制。本研究旨在评估CVR和内皮功能的MS患者，并探讨其与疾病进展的关系，使用功能性超声procedures.MethodsPatients with MS和年龄/性别匹配的健康对照进行了评估内皮功能，确定流量介导的扩张（FMD），和CVR，测量使用屏气指数（BHI）。MS组FMD显著低于对照组（6.0 ± 0.6vs. 8.6± 0.7，p =0.006）;此外，MS中的BHI同样低于对照组，但不显著。值得注意的是，继发进展型MS患者的FMD显著低于复发缓解型MS患者（3.7 ± 1.3vs. 6.7± 0.7，p = 0.045）。此外，FMD与扩展残疾状态量表（R2= 0.170，p = 0.033）和改良兰金量表（R2= 0.187，p = 0.027）的残疾评分呈负相关。结论在MS患者中，内皮功能障碍比CVR损伤更明显，与MS的严重程度和进展相关。
BackgroundImpairment of cerebrovascular reactivity (CVR) has been reported in patients with multiple sclerosis (MS). Chronic inflammation and endothelial dysfunction are possible mechanisms underlying this hemodynamic impairment. This study aimed to evaluate CVR and endothelial function in patients with MS and explore their relationships with disease progression using functional sonographic procedures.MethodsPatients with MS and age-/sex-matched healthy controls were assessed for endothelial function, determined by flow-mediated dilation (FMD), and CVR, measured using the breath-holding index (BHI).ResultsTwenty-seven patients with MS and 24 healthy controls were enrolled. FMD was significantly lower in MS subjects than in control subjects (6.0 ± 0.6vs. 8.6 ± 0.7,p =0.006); furthermore, BHI was similarly lower in MS than in controls, but insignificant. Remarkably, FMD was significantly lower in secondary progressive MS subjects than in relapse-remitting MS subjects (3.7 ± 1.3vs. 6.7 ± 0.7,p= 0.045). In addition, FMD was inversely correlated with the disability score as per the expanded disability status scale (R2= 0.170,p= 0.033) and modified Rankin scale (R2= 0.187,p= 0.027).ConclusionIn patients with MS, endothelial dysfunction was more noticeable than CVR impairment, correlating with the severity and progression of MS.