目的 :探讨微粒化非诺贝特对高三酰甘油血症患者血管内皮功能的作用。方法 :对 30例高三酰甘油血症患者 (口服微粒化非诺贝特 2 0 0mg/d治疗 4周前后 )和 30例正常人采用高分辨超声技术检测血流介导的和硝酸甘油介导的肱动脉舒张功能 ,并测定血浆内皮素 (ET)和血脂。结果 :①高三酰甘油血症组血流介导的肱动脉舒张反应较正常组明显减弱 [(2 .7± 2 .0 ) %∶(15 .0± 8.0 ) % ,P <0 .0 1],而两组对硝酸甘油的血管舒张反应差异无显著性意义 [(15 .0± 5 .0 ) %∶(16 .8± 9.0 ) % ,P >0 .0 5 ]。②高三酰甘油血症患者微粒化非诺贝特治疗后血流介导的肱动脉舒张显著改善 [(11.0± 9.0 ) % ,P <0 .0 1],而硝酸甘油介导的血管舒张较治疗前无明显改变[(16 .2± 6 .0 ) % ,P >0 .0 5 ]。③高三酰甘油血症患者血浆ET水平显著高于正常人 [(10 6 .2± 19.2 ) μg/L∶(72 .4± 14 .1) μg/L ,P <0 .0 1],微粒化非诺贝特治疗后血浆ET水平显著降低 [(82 .7± 15 .5 ) μg/L ,P <0 .0 1],血清三酰甘油明显降低 (P <0 .0 5 )。结论 :微粒化非诺贝特对高三酰甘油血症患者受损的血管内皮依赖性舒张功能有改善作用。改善血管内皮功能亦是微粒化非诺贝特防治冠心病的作用机制之一 Objective: To investigate the effect of micronized fenofibrate on vascular endothelial function in patients with hypertriglyceridemia. Methods: 30 cases of hypertriglyceridemia (oral micronized fenofibrate 200 mg / d for 4 weeks before and after treatment) and 30 normal subjects using high-resolution ultrasound detection of blood-mediated and nitroglycerin-mediated Brachial artery diastolic function, and determination of plasma endothelin (ET) and blood lipids. Results: (1) The diastolic response of brachial artery mediated by blood flow in hypertriglyceridemia group was significantly weaker than that of the normal group [(2.70 +/- 2.0)%: (15.0 +/- 8.0)%, P <0.01 ], While the two groups had no significant difference in the vasodilatory response to nitroglycerin (15.0 ± 5.0% vs (16.8 ± 9.0)%, P> 0.05). (2) The diastolic blood pressure-induced brachial artery diastole was significantly improved in patients with hypertriglyceridemia [(11.0 ± 9.0)%, P <0.01], while nitroglycerin-mediated vasorelaxation No significant change before treatment [(16.2 ± 6.0)%, P> 0.05]. ③ The level of plasma ET in patients with hypertriglyceridemia was significantly higher than that in controls ([(106.2 ± 19.2) μg / L vs (72.4 ± 14.1) μg / L, P <0.01] Serum levels of triglyceride were significantly lower (P <0.05) after treatment with fenofibrate (P <0.01). (82.7 ± 15.5 μg / L, P <0.01). CONCLUSION: Micronized fenofibrate has an effect on impaired endothelium-dependent vasodilatation in patients with hypertriglyceridemia. Improvement of vascular endothelial function is also one of the mechanisms of preventing and treating coronary heart disease by micronized fenofibrate