【摘要】 目的　运用超声显像法评价风湿性心脏病 (风心 )合并心房纤颤 (房颤 )患者血管内皮功能。方法　应用高分辨率超声检测 2 0例风湿性房颤患者、17例风心窦性心律患者及 15例健康正常对照反应性充血和含服硝酸甘油后的肱动脉内径变化 ,并测定血清一氧化氮 (NO)浓度。结果　①与正常对照组相比 ,房颤组反应性充血引起的肱动脉内径变化率 (FMD)明显下降 ( 8.75± 4.79vs 12 .92± 4.5 8,P <0 .0 1) ,风心窦性心律组FMD有下降趋势 ,但差异无显著性 (P>0 .0 5 ) ;房颤组、窦性心律组及正常组三组间硝酸甘油诱导的内径变化率 (GNT -MD)差异无显著性 (P >0 .0 5 )。②房颤组血浆NO浓度较正常对照组 ( 63 .3 8± 9.0 6vs 83 .87± 10 .3 3 ,P <0 .0 1)及窦律组 ( 63 .3 8± 9.0 6vs 69.94± 9.43 ,P <0 .0 5 )显著降低。③房颤组FMD与LA容积呈负性相关 (r =-0 .49,P <0 .0 1) ,与血NO水平呈正相关系 (r =0 .60 ,P <0 .0 1)。结论　风心并发房颤时存在血管内皮依赖性舒张功能受损 ,FMD与患者左房构型有关。更多还原

【Abstract】 Objective To evaluate the endothelial function in rheumatic heart disease (RHD) patient with atrial fibrillation (AF) by ultrasound.Methods Thirty-seven patients with RHD were divided into 2 groups according to AF or SR, and as 15 healthy volunteers the normal control. Endothelial function was evaluated by detecting flow-mediated vasodilatation FMD and after sublin gual trinitrate-mediated vasodilatation(GNT-MD) of brachial artery; plasma hitrous oxide (NO) concentrations was measured.Results ①FMD of brachial artery in RHD patient with AF were significantly lower than that in health subjects,[8.75±4.79 vs 12.92±4.58,(P<0.01)];FMD of brachial artery in RHD patients with SR have decrease tendency, but no significant different when compared with health subjects(P>0.05).The GNT-MD was not significantt in these three groups.②The plasma NO in RHD patients with AF was significantly lower than that in health subjects (63.38 ±9.06 vs 83.87±10.33,P<0.01)and RHD patients with SR(63.38±9.06 vs 69.94±9.43,P<0.05).③FMD in RHD patients with AF showed significant correlation to volume of left atrium (r=-0.49,P< 0.01) and plasma NO levels (r=0.60, P<0.01).Conclusion The endothelial function of RHD patients with AF was impaired. There was correlation between FMD and volume of left atrium.更多还原