Iwamoto Akimichi, Kajikawa Masato, Maruhashi Tatsuya, Iwamoto Yumiko, Oda Nozomu, Kishimoto Shinji, Matsui Shogo, Kihara Yasuki, Chayama Kazuaki, Goto Chikara, Noma Kensuke, Aibara Yoshiki, Nakashima Ayumu, Higashi Yukihito
Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University.
J Atheroscler Thromb. 2016 Nov 1;23(11):1261-1269. doi: 10.5551/jat.35436. Epub 2016 May 9.
Both vascular function and structure are independent predictors of cardiovascular events. The purpose of this study was to evaluate vascular function and structure of a leg artery in patients with peripheral artery disease (PAD).
We measured flow-mediated vasodilatation (FMD) and nitroglycerine-induced vasodilation (NID) as indices of vascular function and intima-media thickness (IMT) as an index of vascular structure of the popliteal artery in 100 subjects, including 20 patients with Buerger disease and 30 patients with atherosclerotic PAD, 20 age- and sex-matched subjects without Buerger disease (control group) and 30 age- and sex-matched patients without atherosclerotic PAD (control group).
IMT was significantly larger in the Buerger group than in the control group (Buerger, 0.63± 0.20 mm; control, 0.50±0.07 mm; P=0.01), whereas there were no significant differences in FMD and NID between the two groups. IMT was significantly larger in the atherosclerotic PAD group than in the control group (atherosclerotic PAD, 0.80±0.22 mm; control, 0.65±0.14 mm; P<0.01), and FMD and NID were significantly smaller in the atherosclerotic PAD group than in the control group (FMD: atherosclerotic PAD, 3.9%±1.1%; control, 5.0%±1.8%; P<0.01; and NID: atherosclerotic PAD, 6.1%±2.0%; control, 8.4%±2.1%; P<0.01).
These findings suggest that vascular function is preserved in patients with Buerger disease and that both vascular function and vascular structure are impaired in patients with atherosclerotic PAD.
血管功能和结构均为心血管事件的独立预测因素。本研究旨在评估外周动脉疾病(PAD)患者腿部动脉的血管功能和结构。
我们测量了100名受试者腘动脉的血流介导的血管舒张(FMD)和硝酸甘油诱导的血管舒张(NID)作为血管功能指标,以及内膜中层厚度(IMT)作为血管结构指标,其中包括20例血栓闭塞性脉管炎患者、30例动脉粥样硬化性PAD患者、20例年龄和性别匹配的无血栓闭塞性脉管炎受试者(对照组)以及30例年龄和性别匹配的无动脉粥样硬化性PAD患者(对照组)。
血栓闭塞性脉管炎组的IMT显著大于对照组(血栓闭塞性脉管炎组,0.63±0.20毫米;对照组,0.50±0.07毫米;P = 0.01),而两组之间的FMD和NID无显著差异。动脉粥样硬化性PAD组的IMT显著大于对照组(动脉粥样硬化性PAD组,0.80±0.22毫米;对照组,0.65±0.14毫米;P<0.01),且动脉粥样硬化性PAD组的FMD和NID显著小于对照组(FMD:动脉粥样硬化性PAD组,3.9%±1.1%;对照组,5.0%±1.8%;P<0.01;NID:动脉粥样硬化性PAD组,6.1%±2.0%;对照组,8.4%±2.1%;P<0.01)。
这些发现表明,血栓闭塞性脉管炎患者的血管功能得以保留,而动脉粥样硬化性PAD患者的血管功能和血管结构均受损。