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心不全における内皮依存性血勘拡張能異常に関する研究

心力衰竭内皮依赖性舒张功能障碍的研究

基本信息

批准号：
04263232
负责人：
竹下彰
金额：
$ 1.6万
依托单位：
Kyushu University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research on Priority Areas
财政年份：
1992
资助国家：
日本
起止时间：
1992 至无数据
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-04263232/
关键词：
心不全血管内皮 No L-アルジニンサブスタンス-P

项目摘要

本年度は心不全における血管拡張障害に、内皮機能がいかに関与するかを心不全患者で検討した。(方法)心不全患者及び対照健康成人の前腕動脈にカニューレを挿入し、薬物注入及び直接的動脈圧測定に用いた。ストレインゲージにより前腕血流量を測定し、血管抵抗を算出した。内皮依存性血管拡張反応はアセチルコリン(ACh)やサブスタンス-P(S-P)を少量、段階的に動注し検討した。内皮非依存性拡張反応はソジウムニトロプルシド(SNP)を動注し検討した。10分間前腕阻血後の反応性充血時の血管拡張反応を検討し、心不全における拡張反応低下が、基質であるL-arginine投与により、改善するかも検討した。(結果)心不全患者では前腕血流量は対照群に比し有意に低下しており、血管抵抗は上昇していた(43±5VS20±2units,PCO.01)。AChによる血管拡張反応は心不全患者で対照者に比し有意に低下していたが(PCO.01)、S-PやSNPによる血管拡張反応は両者間で差がなかった。反応性充血時の最小血管抵抗は心不全患者で対照群に比し有意に大きかった(1.8±0.4VS2.4±0.5units)。L-arginineの前投与はACh高用量投与や反応性充血時の最大血管拡張反応を不全患者のみで増加させたが、対照群では変化させなかった。L-arginineの前投与はS-PやSNPによる血管拡張反応に心不全患者及び対照群で影響しなかった。(結論)これらの結果は心不全患者ではAChによる内皮依存性血管拡張反応低下を示唆する。しかしS-Pによる血管拡張反応に低下はなく、二つのagonistによる内皮依存性血管拡張能の差異の機序は明らかではない。心不全患者に特徴的に認められる反応性充血時の最大拡張能の低下はL-arginineにより改善した。この成績は心不全患者の最大拡張能低下に内皮異常が関与している可能性を示唆する。

This year, patients with cardiac insufficiency have been affected by vascular barrier, endothelial function and patients with heart failure. (methods) patients with congestive heart disease and healthy adults were enrolled in this study. Patients with cardiac insufficiency and healthy adults were randomly divided into three groups. The blood flow of the front wrist was measured and the vascular resistance was calculated. Endothelium-dependent blood vessels (endothelium-dependent blood vessels)-small amount and segment of endothelium-dependent blood vessels (ACh). Endothelium independent response (SNP) is not an endothelium-dependent response. After 10 minutes of occlusion of the anterior wrist, vascular congestion occurred during reversal hyperemia, heart failure caused by hypotension, basal L-arginine infusion, and improvement of heart failure. (results) the blood flow of anterior wrist in patients with heart failure was significantly lower than that in patients with vascular resistance (43 ±5VS20 ±2units, PCO.01). ACh patients with cardiac insufficiency were more likely to have lower blood vessels (PCO.01) than those with cardiac insufficiency (PCO.01), while those with vascular diseases were worse than those with heart failure (PCO.01). The number of patients with minimal vascular resistance during recurrent hyperemia was significantly higher than that of patients with cardiac insufficiency (1.8 ±0.4 VS2.4 ±0.5 units). Before and after L-arginine injection, high dose of ACh and reverse hyperemia, the patients with vascular insufficiency were significantly increased, and the patients with hyperemia were treated with high dose of ACh. The patients with cardiac insufficiency and the group of patients with cardiac insufficiency were treated with L-arginine before and after the injection of Smurp, SNP, blood vessels, blood vessels, blood vessels and blood vessels. (conclusion) the results showed that ACh in patients with cardiac insufficiency showed that endothelium-dependent vascular abnormalities were inversely low. There is no difference in the order of the blood vessels, the blood vessels, the low blood vessels, the endothelium-dependent blood vessels, the agonist vessels, the blood vessels, the endothelium-dependent blood vessels. In patients with cardiac insufficiency, the peak peak of anti-hyperemia was significantly lower than that of L-arginine in patients with cardiac insufficiency. The possibility of hypoendothelialization in patients with cardiac insufficiency is often associated with the possibility of heart failure.