摘要
目的血管内皮位于动脉血管管腔表面，正常的内皮细胞具有调节动脉血管的舒缩、平滑肌增殖、血小板聚集、溶凝血、单核细胞粘附和新生血管生长等功能。其对血管正常功能的作用和导致许多心血管疾病的发病机制，越来越受到一致的认可和重视。目前，众多评估内皮功能的方法包括：血清生化标志物的分析(VCAM、ICAM、E-Selectin、Von-Willebrand's Factor、PAI-1)，尿液一氧化氮(NO)代谢物提取分析，血管对乙酰胆碱和血流增加反应的测定。此外，使用高分辨率B-型超声波扫描检测肱动脉内皮细胞的方法，由于其重复性高与冠状动脉内扫描检测结果一致性好，故进一步得到重视和发展。肱动脉血流介导性扩张障碍最为早期动脉粥样硬化标志，在传统及其他新发现的动脉粥样硬化危险因素的人群中已得到证实。故可为流行病学研究和动脉粥样硬化的预防提供有效的方法。由于内皮功能障碍与冠心病、高血压和心力衰竭等心血管疾病的发病机制有着重要关系，对内皮功能的进一步研究，即可以为心血管病基础研究提供了解动脉粥样硬化发生机制的新信息，又可为临床观察和处理心血管疾病提供新的治疗措施。
Abstract
Objective Endothelial lining of arterial wall is now recognized playing an important role in maintenance of normal vascular function and pathogenesis of many cardiovascular diseases. Endothelial cells regulate contraction (or relaxation) and proliferation of vascular smooth muscle, platelet aggregation, coagulation and monocyte adhesion. More practical methods for assessment of endothelial function include plasma assay of such mediatots (VCAM, ICAM, E-Selectin, Von-Willebrand's Factor, PAI-1 and Nitric Oxide), urinary excretion of nitric oxide metabolites, measurement of vascular reactivity in response to acetycholine and increased flow, and measurement of flow-mediated dilation of brachial artery (EDD) by high resolutions B-mode ultrasonography. The accuracy and high reproducibility of EDD have been documented and correlation with endothelial function measured invasively at coronary artery has been confirmed. Impaired EDD of brachial artery as a surrogate marker of early atherosclerosis (subclinical) has been identified in subjects with traditional and novel atherosclerotic risk factots, offering a new opportunity for epidemiology research and preventive intervention project of atherosclerosis. Endothelial dysfunction is also implicated in initiation and perpectuation of pathogenesis of many cardiovascular disease including coronary artery disease, hypertension and heart failure. This provides a new paradigm for basic science and clinical cardiovascular research, clinical monitoring clinical and pharmaceutical intervention.
NETL
NSTL
维普
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