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Noninvasive evaluation of endothelial function in life style-related diseases

生活方式相关疾病内皮功能的无创评估

基本信息

批准号：
11470518
负责人：
OSHIMA Tetsuya
金额：
$ 7.55万
依托单位：
HIROSHIMA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B).
财政年份：
1999
资助国家：
日本
起止时间：
1999 至 2000
项目状态：
已结题

项目摘要

1. Although there were many reports indicating endothelia dysfunction in the cardiovascular diseases, its evaluation method has not been established in the clinical labortary medicine. The goals of the present study were 1)to establish the routine clinical method to evaluate the endothelium-dependent vasodilation(EDV), and 2)to study the endothelial function in life-style related diseases or coronary risk factors using this methods.2. Forearm blood flow(FBF)was determined by strain-gauge plethysmography. EDV was evaluated as the increases in FBF in response to intra-arterial infusion of acetylcholine(invasive method)and to reactive hyperemia(noninvasive method).3. In patients with essential hypertension(EHT), the both responses of FBF to acetylcholine and reactive hyperemia were attenuated. There was a positive and significant correlation between the results of invasive and noninvasive methods.4. In EHT, EDV was improved by the antihypertensive treatment with ACE inhibitors, but not with calcium antagonists, diuretics or β-blockers. Regular aerobic exercise also improved EVD in EHT.5. In obese patients with EHT, EVD was smaller than in lean patients. The body weight reduction by low calorie diet improved EVD in obese patients.6. In postmenopausal women, EVD was attenuated, but improved by the estrogen replacement therapy.7. In summary, endothelial function can be evaluated by the noninvasive measurements of EDV with reactive hyperemia. EDV was disturbed in EHT, obesity and postmenopausal women. Their disturbed EDV was improved by life style modification and the specific drug treatments.

1. 虽然有许多报道表明内皮功能障碍与心血管疾病有关，但在临床检验医学中尚未建立内皮功能障碍的评价方法。本研究的目的是：1)建立评估内皮依赖性血管舒张（EDV）的常规临床方法；2)利用该方法研究生活方式相关疾病或冠状动脉危险因素中的内皮功能。前臂血流量（FBF）通过应变计体积描记仪测定。EDV通过动脉内灌注乙酰胆碱（有创法）和反应性充血（无创法）后FBF的增加来评估。在原发性高血压（EHT）患者中，FBF对乙酰胆碱和反应性充血的反应均减弱。有创法与无创法检查结果有显著正相关。在EHT中，使用ACE抑制剂治疗可以改善EDV，而钙拮抗剂、利尿剂或β受体阻滞剂则不能改善EDV。有规律的有氧运动也能改善eht患者的EVD。肥胖EHT患者EVD小于瘦弱患者。低热量饮食减轻体重可改善肥胖患者的EVD。在绝经后妇女，EVD减轻，但改善雌激素替代治疗。总之，内皮功能可以通过无创测量EDV伴反应性充血来评估。EHT、肥胖和绝经后妇女的EDV受到干扰。通过改变生活方式和特定药物治疗，他们的EDV紊乱得到改善。