Lind L, Sarabi M, Millgård J
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Clin Physiol. 1998 Mar;18(2):81-7. doi: 10.1046/j.1365-2281.1998.00077.x.
The present study, involving 56 healthy subjects from a health screening, was undertaken to address some methodological questions regarding the measurement of endothelial function using local intra-arterial infusions of metacholine (2 and 5 micrograms min-1) to evaluate endothelium-dependent vasodilatation, and sodium nitroprusside (SNP, 5 and 10 micrograms min-1) to evaluate endothelium-independent vasodilatation. Forearm blood flow (FBF) was measured by venous occlusion plethysmography. The ratio of FBF during the highest dose of metacholine to FBF during the highest dose of SNP was used as an index of endothelial function. In 10 young volunteers the procedure was repeated after 2 h and again after 3 weeks in order to study short-term and long-term reproducibility of the method. Neither the vasodilatatory response to metacholine (r = 0.006) nor that to SNP (r = 0.08) was related to resting FBF. Neither the circumference nor the length of the arm was related to endothelial function (r = 0.01-0.11), as evaluated by the FBF on metacholine to nitroprusside ratio (mean 1.3 +/- 0.3 SD). The use of a wrist cuff to exclude hand circulation, or not, did not influence the evaluation of endothelial function significantly. Maximal FBF after 3 min of arterial occlusion of the forearm was significantly related to blood flow during both metacholine (r = 0.53, P < 0.01) and nitroprusside infusion (r = 0.36, P < 0.05), but not to the FBF on metacholine to nitroprusside ratio (r = 0.01). The short-term and long-term reproducibility of FBF during vasodilatation with metacholine and SNP was good (r = 0.89-0.97, P < 0.001), while the individual measurements for resting FBF were less reproducible when repeated after 3 weeks (r = 0.34). In conclusion, endothelial function was not related to resting FBF, nor to the arm circumference or length. No major difference was seen whether endothelial function was evaluated with or without exclusion of the hand circulation. Maximal FBF during reactive hyperaemia was not related to endothelial function.
本研究纳入了56名来自健康筛查的健康受试者，旨在解决一些方法学问题，这些问题涉及使用局部动脉内输注乙酰甲胆碱（2和5微克/分钟）来评估内皮依赖性血管舒张，以及使用硝普钠（SNP，5和10微克/分钟）来评估非内皮依赖性血管舒张，以此测量内皮功能。通过静脉阻断体积描记法测量前臂血流量（FBF）。将最高剂量乙酰甲胆碱期间的FBF与最高剂量SNP期间的FBF之比用作内皮功能指标。在10名年轻志愿者中，该操作在2小时后重复进行，3周后再次重复，以研究该方法的短期和长期可重复性。乙酰甲胆碱的血管舒张反应（r = 0.006）和SNP的血管舒张反应（r = 0.08）均与静息FBF无关。根据乙酰甲胆碱与硝普钠之比的FBF评估（平均值1.3±0.3标准差），手臂周长和长度均与内皮功能无关（r = 0.01 - 0.11）。使用腕部袖带排除或不排除手部循环，对内皮功能评估无显著影响。前臂动脉阻断3分钟后的最大FBF与乙酰甲胆碱输注期间的血流量（r = 0.53，P < 0.01）和硝普钠输注期间的血流量（r = 0.36，P < 0.05）均显著相关，但与乙酰甲胆碱与硝普钠之比的FBF无关（r = 0.01）。乙酰甲胆碱和SNP血管舒张期间FBF的短期和长期可重复性良好（r = 0.89 - 0.97，P < 0.001），而静息FBF的个体测量在3周后重复时可重复性较差（r = 0.34）。总之，内皮功能与静息FBF无关，也与手臂周长或长度无关。无论是否排除手部循环来评估内皮功能，均未发现重大差异。反应性充血期间的最大FBF与内皮功能无关。
