目的:研究主动脉缩窄矫治术后近中期血管内皮功能的变化,探讨早期手术是否可减轻血管内皮损伤。方法:选取20例主动脉缩窄患儿(Co A组),早期手术组(手术年龄〈6个月)12例,非早期手术组(手术年龄≥6月)8例。同期选择20例健康儿童作为对照组,于手术(或空白处理)前1 d及其后4年,监测四肢血压、充血性反应后右肱动脉血流介导舒张功能(FMD)。结果:两组均未发现静息性高血压。Co A组在术前、术后1、4年右肱动脉FMD均较对照组明显升高(P〈0.05),而Co A早期手术组与非早期手术组比较差异无统计学意义(P〉0.05)。结论:主动脉缩窄矫治术后近中期患儿血压正常,但仍存在血管内皮功能异常,提示手术纠治无法解决血管损害问题,早期手术也未能减轻。
Objective To evaluate the endothelium-dependent vasodilation in children after repair for coarctation of aota(Co A).Methods A group of 20 children having undergone Co A repair between January2010 and October 2010 in Guangzhou Women and Children′ s Medical Center were include in the study,including 12 infants aged less than 6 months and 8 ones aged more than 6 months.Another 20 healthy children were enrolled during the same period as controls.All the subjects underwent monitoring of resting blood pressure and flow-mediated dilation(FMD) of the brachial artery in 4-year follow-up.Results There were no resting hypertension in all subjects,but FMD in the Co A group was higher than in the control group and so it was with the early surgery group and non early surgery group.Conclusion The surgical repair for coarctation of aorta could not cure the vascular function impairment satisfactorily,neither is the early surgery effective in alleviating the injuries in vascular endothelia.