Arora S, Veves A, Caballaro A E, Smakowski P, LoGerfo F W
Microcirculation Laboratory, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
J Vasc Surg. 1998 Jun;27(6):1141-6; discussion 1147. doi: 10.1016/s0741-5214(98)70016-3.
To determine the effect of estrogen on endothelium-dependent relaxation in the cutaneous microcirculation of women.
Three groups of women participated in the study. Group 1 (n = 20) was premenopausal and had a mean age of 39 years (range 24-50 years). Group 2 (n = 9) was postmenopausal and had a mean age of 58 years (range 53-65 years). Group 3 (n = 11) was postmenopausal and taking estrogen replacement therapy; the mean age was 53 years (range 43-58 years). Eleven women in group 1 underwent testing twice, once during menstruation (mean serum estradiol level 73 +/- 30 pg/ml) and once during midcycle (mean serum estradiol level 268 +/- 193 pg/ml; p = 0.003). Single-point laser Doppler ultrasound and laser Doppler imaging with a scanner were used to measure vasodilatation in the forearm skin in response to iontophoresis of 1% acetylcholine (endothelium dependent) and 1% sodium nitroprusside (endothelium-independent smooth muscle relaxant).
All three groups were matched for body mass index and fasting glucose, total, high-density lipoprotein, and low-density lipoprotein cholesterol and triglyceride levels. All women had normal blood pressure, and none smoked. Mean serum estradiol levels were 196 +/- 170 pg/ml (group 1), 35 +/- 12 pg/ml (group 2), and 107 +/- 78 pg/ml (group 3) (p = 0.004). Maximum microvascular vasodilatation (percentage increase over baseline) in response to acetylcholine was reduced in group 2 (93% +/- 43%) compared with group 1 (187% +/- 63%) and group 3 (142% +/- 56%) (p = 0.001). The response to sodium nitroprusside also was diminished in group 2 (73% +/- 27%) compared with group 1 (126% +/- 45%) and group 3 (100% +/- 32%) (p = 0.02). Within group 1 the acetylcholine response was higher during the midcycle phase (186% +/- 31%) compared with the menstrual phase (147% +/- 57%) (p < 0.05). The sodium nitroprusside response also was higher during the midcycle phase (144% +/- 31%) compared with the menstrual phase (94% +/- 41%) (p < 0.05)
The results indicate that estrogens might enhance endothelium-dependent and endothelium-independent vasodilatation in the microcirculation of women.
确定雌激素对女性皮肤微循环中内皮依赖性舒张的影响。
三组女性参与了该研究。第1组（n = 20）为绝经前女性，平均年龄39岁（范围24 - 50岁）。第2组（n = 9）为绝经后女性，平均年龄58岁（范围53 - 65岁）。第3组（n = 11）为绝经后且接受雌激素替代治疗的女性；平均年龄53岁（范围43 - 58岁）。第1组中的11名女性接受了两次测试，一次在月经期间（平均血清雌二醇水平73±30 pg/ml），一次在月经周期中期（平均血清雌二醇水平268±193 pg/ml；p = 0.003）。使用单点激光多普勒超声和带有扫描仪的激光多普勒成像来测量前臂皮肤对1%乙酰胆碱（内皮依赖性）和1%硝普钠（非内皮依赖性平滑肌舒张剂）离子导入的血管舒张反应。
三组在体重指数、空腹血糖、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯水平方面相匹配。所有女性血压正常，且均不吸烟。平均血清雌二醇水平分别为196±170 pg/ml（第1组）、35±12 pg/ml（第2组）和107±78 pg/ml（第3组）（p = 0.004）。与第1组（187%±63%）和第3组（142%±56%）相比，第2组对乙酰胆碱的最大微血管舒张（相对于基线的百分比增加）降低（93%±43%）（p = 0.001）。与第1组（126%±45%）和第3组（100%±32%）相比，第2组对硝普钠的反应也降低（73%±27%）（p = 0.02）。在第1组中，月经周期中期阶段对乙酰胆碱的反应（186%±31%）高于月经期（147%±57%）（p < 0.05）。月经周期中期阶段对硝普钠的反应（144%±31%）也高于月经期（94%±41%）（p < 0.05）。
结果表明，雌激素可能增强女性微循环中内皮依赖性和非内皮依赖性血管舒张。
