ヒト末梢血管硬化度の光電的計測とその臨床的意義

Clinical evaluation of photo-pletysmographic measurement of viscoelastic property in human digital arteries

　末梢血管から直接，伸展性や粘弾性などに関する情報を得ることは動脈硬化症を含む各種循環器疾患の病態を理解するうえで有用である。我々はこれまで末梢血管の弾性特性を光電的に無侵襲計測する装置を試作し，これが実験動物などで動脈硬化症に伴う血管弾性特性の変化をとらえうることを報告してきた^1）。今回この計測法を健常者および冠動脈疾患患者に応用し，得られる末梢血管の弾性指標（硬化度）の臨床的意義を検討した。

A noninvasive technique for measuring the visco-elastic property of the peripheral arterial system has been developed originally in this laboratory. Our provious studies have shown that the change of the vascular elasticity in association with the atheros-clerotic process could be evaluated by this technique in the hyperlipidemic rabbits. In the present study, we applied this method to human digital arteries and tried to evaluate its clinical utility.

Seventy normal subjects and eighty-two patients with coronary artery disease were studied. With advancing age, the elasticity of the peripheral arte-ries had a tendency to decrease in normal subjects. Compared to that of the normal subjects, the ela-sticity of the peripheral arteries decreased signifi-cantly in patients with angiographically proven coronary artery disease (75% or greater narrow-ing). The decrease in the elasticity was especially remarkable in patients with coronary artery disease accompanying systemic hypertension. We conclude that this technique can provide previously unobta-inable data on the elasticity of the peripheral arteries, and these data seem to be useful in understanding the pathogenesis of arteriosclerosis including coronary artery disease.