Hashimoto M, Eto M, Akishita M, Kozaki K, Ako J, Iijima K, Kim S, Toba K, Yoshizumi M, Ouchi Y
Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Arterioscler Thromb Vasc Biol. 1999 Nov;19(11):2795-800. doi: 10.1161/01.atv.19.11.2795.
Endothelial dysfunction has been reported to be the initial step in atherosclerosis. A noninvasive technique that uses ultrasound to measure the intima-media thickness of the carotid artery has been applied to evaluate localized atherosclerosis. This study was undertaken to elucidate whether endothelial dysfunction in the brachial artery is related to the intima-media thickness of the carotid artery. Thirty-four men with atherosclerosis (mean+/-SE age 61+/-2 years) and 33 age-matched men without clinical atherosclerosis were examined. The intima-media thickness and plaque formation of the common carotid artery were assessed by B-mode ultrasonography. We also noninvasively measured brachial artery diameter by the same ultrasound machine when the subjects were at rest, during reactive hyperemia, which causes endothelium-dependent vasodilatation, and after sublingual administration of nitroglycerin, which causes endothelium-independent vasodilatation. The atherosclerosis group had a significantly greater intima-media thickness of the common carotid artery than did the control group (1. 02+/-0.04 versus 0.91+/-0.03 mm, P<0.05). The flow-mediated diameter (FMD) increase (percent FMD=DeltaD/D x 100) in the atherosclerosis group was significantly smaller than that in the control group (2. 8+/-0.4% versus 5.1+/-0.6%, P<0.01). A significant negative correlation between the intima-media thickness of the carotid artery and percent FMD was found in all of the subjects. On multiple regression analysis, percent FMD showed a significant negative correlation with the intima-media thickness of the common carotid artery. These findings support the concept that endothelial dysfunction is significantly related to atherogenesis.
据报道，内皮功能障碍是动脉粥样硬化的起始步骤。一种利用超声测量颈动脉内膜中层厚度的非侵入性技术已被用于评估局部动脉粥样硬化。本研究旨在阐明肱动脉内皮功能障碍是否与颈动脉内膜中层厚度相关。对34名患有动脉粥样硬化的男性（平均±标准误年龄61±2岁）和33名年龄匹配、无临床动脉粥样硬化的男性进行了检查。通过B型超声评估颈总动脉的内膜中层厚度和斑块形成情况。我们还使用同一台超声仪在受试者静息时、反应性充血（导致内皮依赖性血管舒张）期间以及舌下含服硝酸甘油（导致非内皮依赖性血管舒张）后，非侵入性地测量肱动脉直径。动脉粥样硬化组颈总动脉的内膜中层厚度显著大于对照组（1.02±0.04对0.91±0.03mm，P<0.05）。动脉粥样硬化组的血流介导的直径（FMD）增加（FMD百分比=ΔD/D×100）显著小于对照组（2.8±0.4%对5.1±0.6%，P<0.01）。在所有受试者中，发现颈动脉内膜中层厚度与FMD百分比之间存在显著负相关。多元回归分析显示，FMD百分比与颈总动脉内膜中层厚度存在显著负相关。这些发现支持了内皮功能障碍与动脉粥样硬化发生显著相关的观点。
