血管内皮功能诊断:循环系统疾病管理的评价指标与实践

**章　血管内皮功能总论 ···············································································1
一、血管内皮细胞的作用 ················································································1
二、血管内皮功能异常的机制 ··········································································3
三、血管内皮功能异常反映出的问题 ·································································9
四、血管内皮功能检测的临床应用 ·································································· 10
五、血管内皮功能障碍到动脉硬化 ·································································· 12
六、血管内皮功能异常导致冠状动脉痉挛性心绞痛 ············································· 15
七、当前血管内皮功能为何受到关注？ ···························································· 16
八、血管内皮功能在循环系统预防医学中的定位 ················································ 16
第二章　血管内皮功能检测技术 ······································································· 21
一、体积描记法 ·························································································· 21
二、 基于血管超声检测的血流介导的血管扩张 ··················································· 21
三、 可替代FMD 的踝肱指数轻度异常值 ·························································· 22
四、 指端脉搏波反应性充血外周动脉张力 ························································· 23
五、FMD 与RHI 的区别 ··············································································· 24
六、前臂充血与上臂充血 ·············································································· 25
七、反映血管内皮功能的生物标志物 ······························································· 25
八、冠状动脉的内皮功能 ·············································································· 28
第三章　血管内皮功能检测所提供的信息 ··························································· 31
一、血管内皮功能检测的筛查作用 ·································································· 31
二、血管内皮功能检测是动脉硬化进程的评价指标 ············································· 31
三、预测冠状动脉疾病的预后 ········································································ 32
四、冠状动脉痉挛性心绞痛的诊断 ·································································· 33
五、心脏微血管障碍的诊断与疗效评估 ···························································· 33
六、深静脉血栓症的筛查 ·············································································· 34
七、预测外周动脉疾病的预后 ········································································ 35
目　录
2　血管内皮功能诊断——循环系统疾病管理的评价指标与实践
第四章　血管内皮功能障碍相关疾病的发病机制 ·················································· 39
一、一氧化氮 ····························································································· 39
二、炎症 ··································································································· 40
三、氧化应激 ····························································································· 40
四、自主神经 ····························································································· 42
第五章　血管内皮功能提供的临床依据 ······························································ 45
一、血管内皮功能相关的基础研究 ·································································· 45
二、血管内皮功能的临床研究 ········································································ 46
第六章　心血管病及血管内皮功能的相关因素 ····················································· 51
一、冠状动脉疾病家族史 ·············································································· 51
二、少盐 ··································································································· 51
三、吸烟 ··································································································· 52
四、高血压 ································································································ 52
五、糖尿病、糖代谢异常 ·············································································· 53
六、脂质异常 ····························································································· 54
七、高尿酸血症 ·························································································· 55
八、慢性肾病 ····························································································· 55
九、肥胖、代谢综合征 ················································································· 56
十、睡眠呼吸暂停综合征 ·············································································· 57
十一、运动、体育锻炼 ················································································· 57
十二、高龄与性别 ······················································································· 59
十三、心律不齐 ·························································································· 59
十四、动脉硬化性疾病 ················································································· 59
十五、静脉血栓栓塞症 ················································································· 61
十六、心力衰竭 ·························································································· 63
十七、肺动脉高压 ······················································································· 64
十八、血流动力学状态 ················································································· 64
十九、抑郁症 ····························································································· 65
二十、维生素、矿物质 ················································································· 65
二十一、不饱和脂肪酸 ················································································· 66
第七章　血管内皮功能在临床中的应用实践 ························································ 73
一、肥胖患者的减重指导 ·············································································· 74
　目　录　3
二、预防动脉硬化的心血管疾病管理 ······························································· 74
三、心脏康复的风险分层与效果评价 ······························································· 77
四、评价预防缺血性心脏病复发的干预治疗效果 ················································ 78
五、心力衰竭的疗效评价 ·············································································· 79
六、预测心血管不良事件的发生 ····································································· 80
后记············································································································ 83
缩略词一览表································································································ 84
索引············································································································ 88
作者简介······································································································ 90