年轻勃起功能障碍患者的左室舒张功能与内皮功能的相关性.pdf

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第34卷第1期
中山大学学报(医学科学版
ol.34
2013年1月
JOURNAL OF SUN YAT-SEN UNIVERSITY(MEDICAL SCIENCES)
2013
年轻勃起功能障碍患者的左室舒张功能与内皮功能的相关性
姚风娟,黄燕平2,刘东红',林红,范瑞,李翠玲',刘艳秋,陆堃,邓春华1…2
(中山大学附属第一医院1.超声科,2泌尿外科,广东广州510080
摘要:【目的】探讨年轻的无全身其他心血管疾病的阴基勃起功能障碍(ED)患者的血管内皮功能与左室舒张功能的
相关性。【方法】选取我院泌尿外科门诊或住院确诊ED的患者30例作为病例组(平均年龄30.4±4.3岁),健康对照组33例
(平均年29.8±3.9岁)。利用常规超声心动图和组织多普勒方法进行心功能评价。常规超声心动图计算左室射血分数
(EF),二尖瓣E峰、A峰,E/A,左室等容舒张时间(IVRT)、左室等容收缩时间(IVCT)、脉冲血流多普勒Tei指数。组织多普勒
计算二尖瓣后瓣环的E'、A',等容舒张时间(IVRT')、等容收缩时间(IVCT')、心肌做功指数(MPI)、E/E',及血流多普勒与组
织多普勒测量的等容舒张时间差值( TRT-IVRT')。同时测定研究对象的血流介导的肱动脉内皮依赖性舒张功能(FMD)。
结果】与正常对照组相比,ED患者血流介导的内皮依赖性舒张功能降低(8.5%2.7%vs13.4%±2.5%,P<0.001),血流多
普勒Tei指数增大(0.55±0.08vs0.41t0.06,P<0.001),IVRT延长(85.5±13.4msvs61.7±8.4ms,P<0.001),差异均有统
计学意义。FMD与IVRT(r=-0.63)、Tei指数(r=-0.55)及TVRT-IVRT"(r=-0.47)均有显著相关性(P<0.001)。FMD与E/
E'、E、E/A,LVEF均无显著的相关性。【结论】在ED患者,血流介导的肱动脉内皮依赖性舒张功能FMD及左室舒张功能降
低。TVRT作为评价舒张功能的一个敏感指标,与FMD存在显著相关性。
关键词:肱动脉内皮依赖性舒张功能;勃起功能障碍;左室舒张功能
中图分类号:R693.1
文献标志码:A
文章编号:1672-3554(2013)01-0144-04
Relationship between Flow-mediated Dilatation and Left Ventricular Iunction in Young
Patients with Erectile Dysfunction
YAO Feng-juan HUANG Yan-ping, LU Dong-hong LN Hong FAN Rui, LI Cui-ling,
LU Yan-qiu, LU Kun, DENG Chun-hua 1.2
(1. Deparment of ultrasound; 2. Depar ment of Urinary Surgery, The First Affiliated Hospital, Sun Yat-sen University
Guangzhou 510080. China)
Abstract Objective The aim of his study was to assess the relationship between left ventricular diastolic function and forearm
endothelial function in the patients with erectile d union(ED) hout e cardiovascular isease Methods We prospectively
evaluated 30 patients(mean age 30. 4 + 4.3 years )and 33 control subjects(mean age 29.8*3.9 years). LV function wa
classical methods and Doppler tissue imaging(DTT ) Left ventricular ejection fraction(EF), peak early (E)and late(A) transmitral
filling velo te er ra o( LV slme at on m(RT LV isolume ntract time(VT and Tei index
were evaluated by conventional echocardiography. Early diastolic(E late diastolic(A), Myocardial performance index(MP)
isovolumic contraction time(VCT), isovolumic relaxation time(T), the time interval difference of isovolumic relaxation(TVRT
and the ratio of early diastolic mitral inflow velocity o E(E/ ) were obtained by tissue Doppler ima in(TDI)End elial
function, measured as flow-mediated dilatation of the brachial artery using ultrasound, was calculated in the subjects. Results
Endothelium dependent vasodilation(8.5%*2.79%vs 13. 4*2.5%, P< 0.001)was impaired in the ED group than that in the control
roup. And the Tei index(0.55 +0.08 vs 0. 41+0.06, P<0.001) was larger than in the control group. IVRT(85.5+ 13.4 ms vs 61.7
8. 4 ms, P<0.001)was prolonged in the ED group compared with the control group. IVRT, Tei inde and TIVRT-IVRT were significantl
elated to endothelium-dependent vasodilation by bivariate analysis. Conclusions] It was found that endothelial function and left
ventricular diastolic function were impaired in ED patien s. L t en cular s lic function parameters, IVRT, Tei index and TIVRT-
IVRT was related to endothelium-dependent vasodilation in patients with ED without overt cardiovascular disease
Key words endothelial dependent vaso dilation; erectile dysfunction; left ventricular diastolic function
[J SUN Yat-sen
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