2型糖尿病患者血管舒张功能和一氧化氮释放变化及与动脉硬化的关系

目的　探讨 2型糖尿病患者血管舒张功能和一氧化氮释放与糖尿病血管病变的关系。方法　选择 2 0名正常人 (对照组 )和 62例 2型糖尿病患者 (糖尿病组 ) ,并根据患者是否合并冠心病进行分组分析。采用高频超声方法测定反应性充血试验和口服硝酸甘油前后的肱动脉内径变化 ,以反映血管内皮依赖性和非内皮依赖性舒张功能 ,以及静脉闭塞试验测定一氧化氮储备释放 ,同时利用超声方法检测颈总动脉内膜厚度。结果　与对照组比较 ,糖尿病组的非内皮依赖性血管舒张功能无显著变化 (P >0 .0 5 ) ,而内皮依赖性血管舒张功能和内皮一氧化氮释放明显低下 (P<0 .0 5～ 0 .0 1) ,颈总动脉内膜厚度明显增厚 (P <0 .0 1)。糖尿病合并冠心病患者血管内皮依赖性和非内皮依赖性舒张功能均较非合并冠心病患者明显低下。结论　高频超声检测方法能够较好地判断糖尿病患者血管舒张功能。糖尿病患者存在明显的动脉硬化和因一氧化氮释放减少而出现的内皮依赖性舒张功能障碍 ,此与糖尿病性血管病变密切相关     

早期2型糖尿病患者内皮依赖性血管舒张功能改变的研究

目的　探讨早期 2型糖尿病患者内皮功能的变化。方法　选择 5 0例无血管并发症的 2型糖尿病患者 ,和 2 5例年龄、性别匹配的健康个体。采用高分辨血管外超声法检测肱动脉血流介导的内皮依赖性血管舒张功能和硝酸甘油 (GNT)介导的内皮非依赖性血管舒张功能。结果　2型糖尿病组血流介导的血管舒张功能为 3 .62 % ,明显低于对照组的 4.68% (P <0 .0 5 )。基础血管内径、基础血流、GNT介导的血管舒张功能在 2组间无明显差异 (P >0 .0 5 )。结论　早期 2型糖尿病患者内皮依赖性血管舒张功能降低。     

2型糖尿病病人血管内皮依赖性舒张功能的改变

目的　了解 2型糖尿病病人血管内皮依赖性舒张功能的改变。方法　分别选取对照组、2型糖尿病组及 2型糖尿病合并血脂异常组 ,采用高分辨血管外超声法检测其肱动脉血流介导的内皮依赖性舒张功能和硝酸甘油介导的内皮非依赖性舒张功能。同时测定血脂水平。结果　 12型糖尿病组和 2型糖尿病合并血脂异常组内皮依赖性舒张功能较对照组均明显降低 ( P <0 .0 5) ;2型糖尿病合并血脂异常组较 2型糖尿病组有减退 ,但无显著差异 ( P>0 .0 5)。 2 2型糖尿病合并血脂异常组非内皮依赖性舒张功能较 2型糖尿病组及对照组减退 ,差异显著 ( P<0 .0 5) ;2型糖尿病组与对照组无显著性差异 ( P>0 .0 5)。结论　 2型糖尿病对血管内皮功能有影响 ,且影响因素是多方面的 ,既有糖代谢紊乱因素 ,又有脂代谢紊乱因素     

高分辨超声评价2型糖尿病患者血管内皮功能的临床研究

目的采用高分辨超声技术、外周动脉检测法探讨2型糖尿病(T2DM)患者血管内皮依赖性和非依赖性舒张功能变化。方法采用高分辨率超声测量30例T2DM患者和28例正常人在反应性充血及含服硝酸甘油前后肱动脉内径的变化。结果T2DM组血流介导的肱动脉舒张反应明显小于对照组,分别为(6.68±2.78)%和(16.33±3.33)%,P<0.05;硝酸甘油介导的肱动脉舒张反应较对照组明显降低,分别为(6.37±3.59)%和(23.31±6.63)%,P<0.05。结论T2DM患者的血管内皮依赖性舒张功能和非内皮依赖性舒张功能均受损,超声法检测T2DM患者的血管内皮功能对于其病情估计及大血管和微血管并发症的防治有很大作用。     

2型糖尿病患者肱动脉内皮依赖性血管舒张功能与无症状运动心电图阳性关系的研究

目的:研究肱动脉内皮依赖性血管舒张功能在预测2型糖尿病患者并发冠心病中的作用。方法:选择静息心电图正常的2型糖尿病患者98例进行踏车运动实验,筛选无症状运动心电图阳性(ECG+)者(ECG+组,39例),及无症状心电图阴性者(ECG-组,59例)。同时,选择性别、年龄匹配的踏车运动实验正常的健康个体31例作为对照。采用高分辨血管外超声法检测肱动脉血流介导的内皮依赖性血管舒张功能和硝酸甘油介导的内皮非依赖性血管舒张功能。结果:①与对照组比较,ECG+组总胆固醇、低密度脂蛋白胆固醇、甘油三酯、空腹血糖,餐后2小时血糖及C反应蛋白水平明显增高(P<0.05);高密度脂蛋白担固醇水平明显低于对照组(P<0.05)。与ECG-组比较,ECG+组C反应蛋白明显增高(P<0,05)。②ECG-组内皮依赖性血管舒张功能明显低于对照组(P<0.001),ECG+组内皮依赖性血管舒张功能又明显低于对照组和ECG-组(P<0.01)。多元Logistic回归分析结果显示,年龄、低密度脂蛋白胆固醇、脂蛋白(a)、C-反应蛋白、收缩压、舒张压与无症状运动ECG+呈正相关,高密度脂蛋白胆固醇、内皮依赖性血管舒张功能与无症状运动ECG+呈负相关。结论:在2型糖尿病人群中,肱动脉内皮依赖性血管舒张功能与无症状运动ECG+关联,提示肱动脉内皮依赖性血管舒张功能是早期冠心病的预测因子之一。     

彩色多普勒超声对糖尿病血管内皮功能的评价

用高分辨率彩色多普勒超声检测33例2型糖尿病(T2DM)患者肱动脉反应性充血后,以及含服硝酸甘油后的血管内径和血流量变化.结果T2DM组反应性充血时肱动脉内径变化比正常对照组明显减弱(P＜0.01),硝酸甘油介导的肱动脉内径扩张与正常对照组比较有显著性差异(P＜0.05).结论T2DM患者不仅存在血管内皮依赖性舒张功能障碍,而且还存在非血管内皮依赖性舒张功能障碍.     

糖尿病患者内皮tPA、NO储备与血管舒张功能变化

目的　探讨糖尿病患者血管舒张功能和内皮组织纤溶酶原激活物 (tPA)、一氧化氮 (NO)储备释放功能与糖尿病性血管病变的关系。方法　对 15名正常人和 2 3例 2型糖尿病患者 ,采用高频超声方法测定血流介导和硝酸甘油介导的血管舒张功能和颈总动脉内膜厚度 ,以及采用静脉闭塞试验测定tPA和NO储备释放。结果　与正常对照组比较 ,糖尿病组的非内皮依赖性血管舒张功能无显著变化 ,而内皮依赖性血管舒张功能和tPA、NO释放明显低下 (P <0 .0 5或P <0 .0 1) ,颈总动脉内膜增厚 ,但差异无显著性。正常组血tPA水平与NO水平 ,以及tPA释放与NO释放呈显著正相关 ,而糖尿病组收缩压、舒张压均与内皮依赖性血管舒张功能和非内皮依赖性血管舒张功能呈显著负相关。结论　糖尿病患者存在明显的内皮tPA、NO储备释放功能和内皮依赖性舒张功能障碍 ,此与糖尿病性血管病变密切相关     

1型糖尿病早期肱动脉内皮依赖性血管舒张功能已降低

目的　探讨 1型糖尿病(DM)早期患者内皮功能的变化。方法　选择 22例无血管并发症的 1型DM患者和 20名年龄、性别匹配的健康个体。采用高分辨血管外超声法检测肱动脉血流介导的内皮依赖性血管舒张功能和硝酸甘油(GNT)介导的内皮非依赖性血管舒张功能。结果　1型DM组血流介导的血管舒张功能为 3. 83%,明显低于对照组的 4. 87% (P<0. 05)。基础血管内径、基础血流、GNT介导的血管舒张功能在两组间差异无统计学意义(P>0. 05)。结论　早期 1型DM患者就有内皮依赖性血管舒张功能降低。     

糖尿病肾病血管内皮功能的变化及其影响因素

选取2型糖尿病肾病（DN）Ⅳ期患者各49例,记录其病程,空腹测定其血糖、血清胰岛素、糖化血红蛋、血脂,并通过超声测定其肱动脉血管内径、基础血流、内皮依赖性血管舒张功能及硝酸甘油介导的血管舒张功能,通过rrc一二已三胺乙酸ECT法测定肾小球滤过率,并与同期住院的无血管并发症的2型糖尿病患者24人进行比较。结果糖尿病肾病Ⅳ期患者内皮依赖性血管内径变化率为2.93%±0.73G,低于无血管并发症的糖尿病4.61%±0.52%,其变化与高密度脂蛋白胆固醇、H01TIa-、GFR呈正相关,与饮食中蛋白质含量、糖尿病病程、糖化血红蛋白、24h尿白蛋白排泄、Hom a IR呈负相关。结论糖尿病肾病Ⅳ期已存在明显的内皮功能受损,高蛋白饮食是其重要的影响因素之一。     

彩色多普勒超声对糖尿病血管内皮功能的评价

用高分辨率彩色多普勒超声检测33例2型糖尿病（T2DM）患者肱动脉反应性充血后，以及含服硝酸甘油后的血管内径和血流量变化。结果：T2DM组反应性充血时肱动脉内径变化比正常对照组明显减弱（P〈0．01），硝酸甘油介导的肱动脉内径扩张与正常对照组比较有显著性差异（P〈0．05）。结论：T2DM患者不仅存在血管内皮依赖性舒张功能障碍，而且还存在非血管内皮依赖性舒张功能障碍。     

Impaired endothelium-dependent vascular responses of retinal and intrarenal arteries in patients with type 2 diabetes.

Endothelial dysfunction has been implicated in the pathogenesis of diabetic microangiopathies such as retinopathy and nephropathy as well as macrovascular diseases. The aim of the current study was to determine whether endothelial function in the retinal and renal arteries is impaired in type 2 diabetes mellitus. We examined the effects of an intravenous infusion of L-arginine and a sublingual administration of nitroglycerin on the brachial, retinal, and interlobar arterial hemodynamics in 20 type 2 diabetic patients (10 with normoalbuminuria and 10 with microalbuminuria) and 10 aged-matched control subjects. Despite no difference in the nitroglycerin-induced vascular response of the brachial or retinal artery among the 3 groups, the L-arginine-induced vascular response of each artery was significantly lower in both the normoalbuminuric and microalbuminuric patients than in the control subjects and the microalbuminuric patients showed the lowest value among the 3 groups (P<0.01, each artery, respectively). The L-arginine-induced vascular response of each artery was significantly correlated with HbA1c levels (brachial artery, r=0.617, P=0.0003; retinal artery, r=0.599, P=0.0005; interlobar artery, r=0.636, P=0.0002). In addition, stepwise multiple regression analysis of all subjects showed that HbA1c level was an independent determinant for the L-arginine-induced vascular response of each artery. The results showed that the endothelium-dependent vascular responses of the retinal and intrarenal arteries as well as the brachial artery were impaired in diabetic patients before the clinical manifestation of diabetic nephropathy, and suggest that endothelial dysfunction in these arteries is associated with hyperglycemia in these patients.     

高分辨率超声技术评价病毒性心肌炎患者血管内皮功能的改变

目的:采用高分辨率超声技术探讨病毒性心肌炎患者血流介导的肱动脉舒张反应(FMD)和硝酸甘油介导的肱动脉舒张反应(NMD).方法:采用高分辨率超声技术检测30例病毒性心肌炎患者(心肌炎组)的内皮功能,并与20例非心肌炎患者(非心肌炎组)及20例健康体检者(正常对照组)做比较.结果:心肌炎组FMD(8.73±2.87)%和非心肌炎组FMD(13.00±2.79)%均低于正常对照组(19.32±2.67)%,且差异有统计学意义(P均＜0.01),心肌炎组FMD低于非心肌炎组,差异有统计学意义(P＜0.01).心肌炎组NMD(19.68±5.84)%、非心肌炎组NMD(23.18±4.28)%及正常对照组NMD(24.24±4.13)%3组比较差异无统计学意义(P＞0.05).结论:病毒性心肌炎患者血管内皮依赖性舒张功能受损明显,而非内皮依赖性舒张功能变化不明显.     

Relationship between diabetic retinopathy and vascular endothelial function in elderly type 2 diabetic Japanese patients without cardiovascular disease

Background:   Many recent studies point to the importance, in diabetic patients, of vascular endothelial function as an early marker of not only macrovascular complications but also of microangiopathy. The aim of this study is to investigate the relationship between diabetic retinopathy and endothelial function in elderly diabetic patients by using brachial artery flow-mediated dilation (FMD).
Methods:   We studied 71 type 2 diabetic patients aged 65 years or older without cardiovascular diseases. The subjects were categorized as three groups: (i) without diabetic retinopathy ( n  = 49); (ii) with non-proliferative diabetic retinopathy group ( n  = 15); and (iii) those with preproliferative or proliferative diabetic retinopathy ( n  = 7). Brachial artery FMD measurement was performed by high-resolution ultrasonography. The Kruskal–Wallis test, the χ² test and multivariate logistic regression analysis were used to identify associations between both retinopathy and clinical characteristics and FMD.
Results:   There were no differences in clinical characteristics between the three groups. FMD of the three groups were significantly decreased correlating with the severity of retinopathy (8.03% vs 5.40% vs 2.30%; P  = 0.003). Multivariate logistic regression analysis showed that there was a significant correlation between diabetic retinopathy and FMD (odds ratio 0.801; P  = 0.009).
Conclusion:   Our study suggests that FMD has a relation to microangiopathy in elderly diabetic subjects. Prospective studies will be required to determine whether this test has any clinical use for identifying elderly diabetic patients who are likely to develop diabetic retinopathy.     

Cardiorenal syndrome in type 1 diabetes mellitus: the role of endothelial dysfunction

AIM: To elucidate the role of endothelial dysfunction in formation of cardiorenal syndrome in patients with type 1 diabetes and diabetic nephropathy. MATERIAL AND METHODS: Sixty patients with type 1 diabetes were divided according to severity of nephropathy into the following groups: with normal albuminuria (n=15), microalbuminuria (n=15), proteinuria (n=15), and chronic renal failure (n=15). Control group consisted of 15 healthy subjects of similar age and sex. Methods of investigation included assessment of brachial artery endothelium dependent dilation by duplex scanning during test with reactive hyperemia, measurement of levels of serum markers of endothelial dysfunction (endothelin-1, von-Willebrand factor), and inflammation (C-reactive protein), analysis of parameters of 24-hour blood pressure monitoring and echocardiography data. RESULTS: More severe diabetic nephropathy was associated with higher prevalence of cardiac pathology. Frequency of ischemic heart disease was 13 (2/15), 33 (5/15) and 53% (8/15), frequency of left ventricular concentric hypertrophy and remodeling - 33 (5/15), 40 (6/15) and 60% (9/15) among patients with microalbuminuria, proteinuria and chronic renal failure, respectively. Abnormalities of 24-hour blood pressure rhythm as well as signs of endothelial dysfunction were more pronounced in patients with more severe nephropathy. Correlation analysis revealed significant relationships between markers of endothelial dysfunction, parameters of renal function, blood pressure level and mass of left ventricular myocardium. CONCLUSION: In patients with type 1 diabetes: endothelial dysfunction represents a link integrating processes of progression of nephropathy and development of cardiovascular pathology; close relationship between these processes constitutes a basis of cardiorenal syndrome; active search for cardiac pathology should be initiated on the stage of microalbuminuria.     

Non-invasive assessment of arterial stiffness by pulse-wave velocity correlates with endothelial dysfunction

BACKGROUND: Pulse-wave velocity is the speed of the blood pressure wave to travel a given distance between two sites of the arterial system and is determined by the elasticity, wall thickness and blood density. Pulse-wave velocity correlates well with arterial distensibility and stiffness and is a useful non-invasive index to assess arteriosclerosis. Arterial endothelial dysfunction is one of the key early events in atherogenesis, preceding structural atherosclerotic changes. This study sought to establish the correlation of non-invasive estimation of arterial wall stiffness by pulse-wave velocity and its association with endothelial dysfunction in subjects at higher risk for atherosclerosis. METHODS AND RESULTS: A total of 102 subjects (60 males and 42 females, mean age 51 years), including those with hypertension (n = 39), type 2 diabetes mellitus (n = 26), concomitant type 2 diabetes mellitus and hypertension (n = 29) and primary dyslipidemia without diabetes mellitus and hypertension (n = 8). Pulse-wave velocity was measured by the Vascular Profiler 1000 (VP-1000) waveform analysis and vascular evaluation system, an automated, non-invasive, screening device. Endothelial function was assessed by flow-mediated dilation of the brachial artery. The brachial-artery diameter was measured on B-mode ultrasound images, with the use of a 7.0 MHz linear-array transducer. Mean brachial artery pulse-wave velocity on the right extremity was 1699 cm/s and on the left 1694 cm/s. Mean flow-mediated dilation in the study subjects was 3.6 +/- 8.4%. Mean brachial artery pulse-wave velocity in the right and left extremities and the higher value of brachial artery pulse-wave velocity of the two extremities showed a negative and significant correlation with flow-mediated dilation of the brachial artery (correlation coefficient r = -0.32, p = 0.001; r = -0.40 p < 0.0001; r = -0.37, p = 0.001, respectively). Mean heart-brachial pulse-wave velocity also showed a negative and significant correlation with flow-mediated dilation of the brachial artery (r = -0.23, p = 0.022). Mean arterial stiffness was 36.2 +/- 22%. Arterial stiffness in the right extremity and the higher value of the two extremities showed a negative and significant correlation with flow-mediated dilation of the brachial artery (correlation coefficient r = -0.31, p = 0.002; r = -0.32, p = 0.001, respectively). CONCLUSIONS: Increased values of pulse-wave velocity reflecting upon arterial stiffness show an excellent correlation with reduced values of brachial artery flow-mediated dilation. We propose that the non-invasive modalities of estimation of the pulse-wave velocity and endothelial function estimation by flow-mediated dilation of brachial artery be used in clinical practice in assessment of pre-clinical atherosclerosis.     

卡维地洛对急性心肌梗死患者内皮功能及氧化指标的影响

目的观察卡维地洛对急性心肌梗死(AMI)患者血管内皮依赖性舒张功能及血清氧化指标——丙二醛(MDA)的影响。方法将52例AMI患者随机分成卡维地洛治疗组(28例)和常规治疗组(24例),比较观测治疗8周前后超声检测肱动脉流量介导性扩张的血管内皮依赖舒张功能及血清MDA的变化。结果治疗前两组比较,内皮依赖性血管舒张功能差异无统计学意义;卡维地洛治疗8周后内皮依赖性血管舒张功能明显改善;血清MDA水平明显降低,与治疗前比较,差异均有统计学意义(P<0.05或P<0.01)。结论卡维地洛在治疗8周后通过降低血清MDA水平的抗氧自由作用,可明显改善AMI患者血管内皮依赖舒张功能。     

老年杓型与非杓型高血压患者踝臂指数变化的临床意义

目的探讨老年杓型与非杓型高血压患者踝臂指数(ankle brachial index,ABI)的异常情况及临床意义。方法选择老年原发性高血压患者79例进行24 h动态血压监测,分为非杓型组52例和杓型组27例。测定ABI、高敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)、髓过氧化物酶(myeloperoxidase,MPO)水平和血管内皮功能。结果非杓型组ABI、肱动脉内皮依赖性舒张功能较杓型组明显降低,MPO、hs-CRP较杓型组明显升高,差异有统计学意义(P<0.05)。非杓型组患者ABI与hs-CRP和MPO呈负相关(r=-0.723,r=-0.71 9,P<0.01),与肱动脉内皮依赖性舒张功能呈正相关(r=0.91 7,P<0.01)。结论 ABI降低与斑块不稳定、炎性反应及血管内皮功能受损密切相关,对评价夜间老年高血压患者动脉结构、功能的损害程度、判断预后、指导合理治疗有重要的临床意义。     

高血压患者动脉缓冲功能和内皮调节功能临床研究

研究高血压患者动脉缓冲功能和内皮调节功能的损害 ,为临床选择敏感反映高血压患者预后危险性的指标。对 54例原发性高血压患者和 16例正常人应用自动脉搏波速度 (PulsewavevelocityPWV)测定仪进行检测 ,颈动脉 -股动脉PWV(CPWV)作为反映动脉扩张性 (Distensibility)的参数 ,并能敏感反映动脉缓冲功能的改变。二维超声分别测定肱动脉横断面顺应性 (CSC) ,容积扩张性 (VD)和内皮依赖性血管扩张功能用于评价动脉缓冲功能和内皮功能。CPWV在高血压组显著升高 (P =0 .0 4 83) ,CSC ,VD高血压组显著低于正常对照组(P =0 .0 30 2 ,P =0 .0 196 ) ,内皮依赖性血管扩张功能在高血压组显著降低 (P =0 .0 130 )。多因素分析结果表明VD是与内皮功能关系最为密切的因素 (r =0 .3995,P =0 .0 0 11)。结论为高血压可导致动脉缓冲功能和内皮功能的损害 ,内皮功能障碍是动脉缓冲功能降低的原因。二维超声检测动脉扩张性的改变能敏感反映高血压患者动脉缓冲功能和内皮功能的损害 ,为临床提供了一个重要的无创指标 ,具有广阔的应用价值。     

The effects of troglitazone,an insulin-sensitizing agent,on the endothelial function in early and late type 2 diabetes: a placebo-controlled randomized clinical trial

Activation of the peroxisome proliferator-activator receptor gamma (PPARgamma) improves insulin resistance and glycemic control in patients with diabetes. As PPARgamma is expressed in the endothelial cell, we have investigated the effect of troglitazone, a PPARgamma activator, on the endothelial function in people with type 2 diabetes in a 12-week, prospective, randomized, double-blinded clinical trial. We studied 87 type 2 diabetic patients who were divided into 3 groups. Group A consisted of 27 patients with recently diagnosed diabetes and no clinical manifestations of macrovascular disease; group B, 29 patients with long-term diabetes and no clinically evident macrovascular disease; and group C, 31 diabetic patients with documented macrovascular disease (cardiovascular, cerebrovascular, or peripheral vascular disease). High-resolution ultrasound images were used to measure the flow-mediated dilation (FMD, endothelium-dependent) and nitroglycerin-induced dilation (NID, endothelium-independent) in the brachial artery. Laser Doppler perfusion imaging was used to measure vasodilation in the forearm skin in response to iontophoresis of 1% acetylcholine (Ach, endothelium-dependent) and 1% sodium nitroprusside (NaNP, endothelium-independent). The plasma concentrations of von Willebrand factor (vWF), soluble intercellular adhesion molecule (sICAM), and soluble vascular cell adhesion molecule (sVCAM) were also measured as indicators of endothelial cell activation. The FMD improved in the troglitazone-treated patients in group A (7.72 +/- 3.4 v 5.27 +/- 2.0, P <.05 [exit visit v baseline, percent of increase in brachial artery diameter, mean +/- SD]). The fasting insulin level also improved in this group (15.6 +/- 10 v 19.7 +/- 10, P <.05) and was strongly correlated to changes in FMD (r = -.73, P <.01). No changes were found in the FMD or the fasting insulin levels in the troglitazone-treated patients in groups B or C. The NID was not changed by troglitazone treatment in any of the 3 groups. Also, no differences were found in the microcirculation reactivity measurements or in the biochemical markers of endothelial dysfunction in all 3 groups. A small, but significant, improvement of the FMD was found in placebo-treated patients in group B, probably related to the low FMD levels at baseline in the patients (5.40 +/- 3.0 v 4.36 +/- 2.4, P <.05). We concluded that troglitazone treatment for 12 weeks improved endothelial function in the macrocirculation of patients with recently diagnosed type 2 diabetes and no clinical evidence of macrovascular disease. This improvement was strongly associated with the improvement of fasting plasma insulin concentrations.     

餐后高血糖对肱动脉内皮依赖性舒张功能的影响

目的应用多普勒超声技术检查餐后高血糖患者的血管肉皮功能,探讨餐后高血糖对动脉粥样硬化的影响。方法选择新诊断2型糖尿病患者46例,采集静脉血测TC、TG、LDL-C、HDL-C、血糖、胰岛素、糖化血红蛋白(HbAlc)、高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP),并行口服葡萄糖耐量试验后测餐后2 h血糖(2 h PG)及餐后2 h胰岛素(2 h INS)。将其结果分为空腹高血糖组(空腹高血糖惠者21例)及餐后高血糖组(餐后高血糖患者25例),同期选择血糖正常者20例作为对照组,测定3组的肱动脉内皮依赖性舒张功能(endothelium-dependent dilation,EDD)。结果餐后高血糖组和空腹高血糖组患者肱动脉EDD、TC、LDL-C、HDL-C、空腹血糖、2 h PG、2 h INS、HbAlc、hs-CRP与对照组比较.差异有统计学意义(P<0.05,P<0.01)。餐后高血糖组患者肱动脉EDD较空腹高血糖组明显降低[(3.58±1.04)%vs(4.86±0.92)%.P<0.01]。多因素逐步回归分析显示,EDD与2 h PG、HbAlc、TC呈明显负相关(r分别为-0.77、-0.61、-0.57,P<0.01)。结论餐后高血糖较空腹高血糖对血管内皮功能危害更大.加强餐后高血糖的控制对延缓动脉粥样硬化更为重要。