【作者】 李华；

【导师】 张赛丹；

【作者基本信息】 中南大学 ， 内科学， 2008， 硕士

【摘要】 目的:探讨颈股动脉脉搏波传导速度(carotid-femoral pulse wavevelocity,cf-PWV)与血尿酸及肱动脉血流介导的内皮依赖性舒张功能(flow-mediated dilatation,FMD)的关系。方法:收集已接受冠脉造影者173例,其中冠心病者113例,非冠心病者60例。采用PP-1000动脉弹性检测仪测定cf-PWV,静脉抽血查清晨空腹血清尿酸浓度,采用高分辨率超声检测FMD。结果:1.冠心病者cf-PWV及血尿酸浓度高于非冠心病者(11.00±2.74比8.95±1.50;392.64±92.34比325.29±97.27;均P＜0.01),而FMD低于后者(7.50±2.26比10.03±1.97;P＜0.01)。2.在所有受试者中,单因素直线相关分析显示cf-PWV与血尿酸显著正相关(r=0.636,P＜0.001),与FMD显著负相关(r=-0.668,P＜0.001);以cf-PWV为因变量,年龄(Age)、性别、体重指数(BMI)、高血压(HBP)、糖尿病(DM)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、血尿酸及FMD为自变量行多元逐步回归分析显示,年龄、高血压、糖尿病、LDL-C、TG及血尿酸与cf-PWV分别呈独立正相关关系,FMD与cf-PWV呈独立负相关关系。3.在所有受试者中,单因素直线相关分析发现血尿酸与FMD呈显著负相关(r=-0.608,P＜0.001);以FMD为因变量,年龄、性别、BMI、高血压、糖尿病、LDL-C、HDL-C、TG及血尿酸为自变量的多元逐步回归分析中显示,年龄、高血压、糖尿病、LDL-C及血尿酸与FMD呈独立负相关关系。结论:1.冠心病患者的cf-PWV显著高于非冠心病者,cf-PWV对冠心病可能有一定的辅助诊断价值。2.cf-PWV与血尿酸水平呈正相关关系,血尿酸可能是动脉硬化的独立危险因素。3.cf-PWV与FMD、FMD与血尿酸分别呈显著负相关,血尿酸可能通过损伤血管内皮功能促使动脉硬化的发生和发展。更多还原

【Abstract】 Objective:To investigate the relationship between carotid-femoral pulse wave velocity(cf-PWV)、the serum uric acid and flow-mediated dilatation(FMD)of brachial artery.Methods:Carotid-femoral pulse wave velocity(cf-PWV)was measured using PP-1000 automated analyzer.Fast serum uric acid(SUA) was measured in the morning.Flow-mediated dilation(FMD)in the brachial artery was measured using high resolution ultralsound assessment of the brachial artery diameter.Results:113 patients with CHD and 60 non-CHD were recruited in the study.Cf-PWV and SUA was higher in CHD as compared to the non-CHD group(11.00±2.74 vs 8.95±1.50,P＜0.01;392.64±92.34 vs 325.29±97.27;P＜0.01).FMD was lower in CHD as compared to the non-CHD group(7.50±2.26 vs 10.03±1.97;P＜0.01).Univariate analysis demonstrate that there was a significant relationship between SUA and cf-PWV、FMD(P＜0.01).In all recruited subjects,multivariate stepwise regression analysis demonstrated that SUA and FMD were significant and independent factors for cf-PWV and SUA was an independent factor for FMD.Conclusions:Compared with patients without CHD,there were higher cf-PWV in patients with CHD.PWV might have some value for CHD diagnosis.Cf-PWV was positively correlated with SUA and SUA might be involved to the pathogenesis of arteriosclerosis.FMD was negatively correlated with SUA and PWV.Maybe the underline mechanism between SUA and arteriosclerosis is the vascular endothelial dysfunction.更多还原