【摘要】 为探讨内源性雌激素对女性冠心病患者血管内皮功能的作用及其可能机制 ,采用高分辨力超声法测定33例女性冠心病患者和 17例对照者血流介导的肱动脉舒张反应 ,用双抗体放射免疫法测定血浆雌二醇水平 ,高效液相色谱仪测定血浆非对称性二甲基精氨酸含量。结果发现 ,冠心病患者血流介导的肱动脉舒张反应明显低于对照者 (1.73%± 1.2 6 %比 5 .37%± 3.2 0 % ,P <0 .0 0 1) ,冠心病患者雌二醇水平也明显低于对照者 (2 7.80± 12 .2 8ng L比 4 3.83± 14 .30ng L ,P <0 .0 1) ,而冠心病患者非对称性二甲基精氨酸水平明显高于对照者 (3.39± 1.0 7μmol L比1.31± 0 .6 9μmol L ,P <0 .0 0 1)。血流介导的肱动脉舒张反应与雌二醇水平呈正相关 (β =0 .314 ,P <0 .0 5 ) ,与非对称性二甲基精氨酸水平呈负相关 (β=- 0 .30 2 ,P <0 .0 5 ) ,且雌二醇水平与非对称性二甲基精氨酸呈独立负相关 (r=- 0 .5 4 4 ,P <0 .0 0 1)。结果提示 ,女性冠心病患者血管内皮依赖性舒张功能降低。内源性雌激素水平的降低及其所伴随的非对称性二甲基精氨酸水平增高对女性冠心病患者血管内皮功能有损害作用。更多还原

【Abstract】 Aim To investigate the effect of endogenous estrogen levels on vascular endothelial function and its mechanism in women with coronary heart disease (CHD). Methods Flow mediated dilatation (FMD) of the brachial artery were detected by use of high resolution ultrasound in 33 women with CHD and 17 matched controls. Plasma estradiol were measured by radioimmulogy. Plasma concentrations of asymmetric dimethylarginine (ADMA) were measured by high performance liquid chromatopraphy. Results In comparison with control group, FMD significantly decreased in the CHD group (1.73%±1.26% vs 5.37%±3.20%, P<0.001). Plasma estradiol levels were lower in the CHD group than in the controls (27.80±12.28 ng/L vs 43.83±14.30 ng/L, P<0.01), whereas ADMA concentrations were higher in the CHD group than in the controls (3.39±1.07 μmol/L vs 1.31±0.69 μmol/L,P<0.001). FMD was positively correlated with plasma estradiol levels (β=0.314, P<0.05), but negatively correlated with ADMA (β=0.302, P<0.05). Plasma estradiol levels inversely correlated with ADMA concentrations (r=-0.544, P<0.001). Conclusions This study indicates that endothelium dependent vasodilatation is impaired in women with CHD. The decrease of endogenous estrogen levels accompanied with the increase of ADMA concentrations may involve in one of the mechanisms of endothelial dysfunction in women with CHD.更多还原