Corretti M C, Plotnick G D, Vogel R A
Department of Medicine, University of Maryland School of Medicine, Baltimore, USA.
Clin Cardiol. 1995 Aug;18(8):471-6. doi: 10.1002/clc.4960180810.
Impaired endothelium-dependent vasomotion in response to flow-mediated, cholinergic, and cold pressor stimulation has been demonstrated in the presence of both atherosclerosis and cardiac risk factors. This study investigated the effects of different vasoactive stimuli on brachial artery vasomotion with respect to age and gender. Forty healthy subjects (20 men and 20 women), ages 23 to 52 years, were studied. Using 7.5 MHz ultrasound, brachial artery diameter and Doppler flow velocity at baseline, following 5 min of ipsilateral blood pressure cuff occlusion (flow-mediated), during contralateral hand immersion in ice (cold pressor) and after sublingual nitroglycerin administration, were measured in older subjects (> 40 yrs) and younger subjects (< 40 yrs). Among normal subjects, % diameter change in response to the flow-mediated stimulus was less in older men than in younger men (6.8 +/- 3.2% vs. 11.5 +/- 7.4%, p < 0.05); older and younger women had comparable responses (10.0 +/- 5.3% vs. 11.6 +/- 4.3%, p = NS). With cold pressor, normal older men and older women vasoconstricted (-1.2 +/- 0.9%, -2.2 +/- 4.7%) compared with younger subjects who vasodilated (1.4 +/- 2.5%, 0.6 +/- 2.3%, p < 0.02). The cold pressor test elicited comparable responses among older normal subjects. Nitroglycerin, a non-endothelium-mediated stimulus, induced significant vasodilatation in all the groups. In conclusion, endothelium-mediated responses in subjects of varying age and gender are stimulus-dependent. Flow-mediated vasodilatation could not differentiate older premenopausal women from younger women; cold pressor stimulus could.
在存在动脉粥样硬化和心脏危险因素的情况下，已证实内皮依赖性血管运动对血流介导、胆碱能和冷加压刺激的反应受损。本研究调查了不同血管活性刺激对肱动脉血管运动的影响，并考虑了年龄和性别因素。研究对象为40名年龄在23至52岁之间的健康受试者（20名男性和20名女性）。使用7.5兆赫超声，测量了老年受试者（>40岁）和年轻受试者（<40岁）在基线时、同侧血压袖带闭塞5分钟后（血流介导）、对侧手浸入冰水中时（冷加压）以及舌下含服硝酸甘油后肱动脉直径和多普勒流速。在正常受试者中，老年男性对血流介导刺激的直径变化百分比低于年轻男性（6.8±3.2%对11.5±7.4%，p<0.05）；老年和年轻女性的反应相当（10.0±5.3%对11.6±4.3%，p=无显著性差异）。冷加压时，正常老年男性和老年女性血管收缩（-1.2±0.9%，-2.2±4.7%），而年轻受试者血管舒张（1.4±2.5%，0.6±2.3%，p<0.02）。冷加压试验在老年正常受试者中引起的反应相当。硝酸甘油是一种非内皮介导的刺激物，在所有组中均诱导显著的血管舒张。总之，不同年龄和性别的受试者中内皮介导的反应是刺激依赖性的。血流介导的血管舒张不能区分绝经前老年女性和年轻女性；冷加压刺激可以。
