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结节病与内皮功能、动脉壁特性和炎症生物标志物的关系。

Association of sarcoidosis with endothelial function, arterial wall properties, and biomarkers of inflammation.

机构信息

1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece.

出版信息

Am J Hypertens. 2011 Jun;24(6):647-53. doi: 10.1038/ajh.2011.30. Epub 2011 Mar 3.

Abstract

BACKGROUND

Sarcoidosis is an inflammatory disease, which may affect vascular function. The study was designed to assess the impact of sarcoidosis on endothelial function and arterial stiffness.

METHODS

Eighty-seven sarcoidosis patients and eighty-seven matched healthy subjects (Cl) were included in the study. Sarcoidosis patients were divided into two groups. Group 1 included patients never treated and group 2 included patients receiving cortisone treatment. Endothelial function was evaluated by flow-mediated dilatation (FMD). Carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness and augmentation index (AI75) as a measure of arterial wave reflections. Serum levels of soluble intercellular adhesion molecule-1 and tumor necrosis factor-α (TNF-α), were measured.

RESULTS

In the totality of the population, sarcoidosis patients had significantly lower FMD (P < 0.01) and significantly higher AI75 (P < 0.05). There was also a significant difference, between group 1, and Cl in FMD and AI75, but there was no difference between group 2 and Cl in FMD and AI75. AI75 values were significantly correlated with serum levels of intercellular adhesion molecule-1 (ICAM-1) (r = 0.370, P < 0.01) and TNF-α (r = 0.219, P = 0.049).

CONCLUSIONS

In the present study, we have shown that sarcoidosis patients have impaired endothelial function and increased arterial stiffness. Sarcoidosis patients on cortisone treatment had no differences compared to controls on the vascular parameters. Moreover, there was a significant correlation between inflammatory process and vascular function impairment. These findings indicate that sarcoidosis patients have impaired vascular function and increased inflammatory status, which may improve with cortisone treatment.

摘要

背景

结节病是一种炎症性疾病,可能影响血管功能。本研究旨在评估结节病对内皮功能和动脉僵硬度的影响。

方法

本研究纳入了 87 例结节病患者和 87 例匹配的健康对照者(Cl)。结节病患者分为两组,组 1 为从未接受治疗的患者,组 2 为接受皮质激素治疗的患者。采用血流介导的扩张(FMD)评估内皮功能,以颈动脉-股动脉脉搏波速度(PWV)作为主动脉僵硬度的指标,以增强指数(AI75)作为动脉波反射的指标。检测血清可溶性细胞间黏附分子-1 和肿瘤坏死因子-α(TNF-α)水平。

结果

在总体人群中,结节病患者的 FMD 显著降低(P < 0.01),AI75 显著升高(P < 0.05)。组 1 与 Cl 之间的 FMD 和 AI75 也存在显著差异,但组 2 与 Cl 之间的 FMD 和 AI75 无差异。AI75 值与血清细胞间黏附分子-1(ICAM-1)水平呈显著相关(r = 0.370,P < 0.01),与 TNF-α水平呈显著相关(r = 0.219,P = 0.049)。

结论

本研究表明,结节病患者存在内皮功能障碍和动脉僵硬度增加。接受皮质激素治疗的结节病患者与对照组在血管参数方面无差异。此外,炎症过程与血管功能障碍之间存在显著相关性。这些发现表明,结节病患者存在血管功能障碍和炎症状态增加,皮质激素治疗可能改善这些情况。

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