糖代谢异常、NO、CRP及颈动脉内膜中层厚度之间关系的研究

目的研究从糖耐量正常、糖耐量低减至糖尿病发展过程中血一氧化氮(NO)、超敏C-反应蛋白(CRP)的变化,探讨其与糖尿病早期动脉硬化颈动脉内膜中层厚度(intimal-medialthickness,IMT)的关系。方法90例患者,其中糖耐量正常、糖耐量低减、2型糖尿病各30例,每例均晚间禁食后抽血行包括NO、CRP在内的生化检查及超声检测颈动脉内膜中层厚度。结果从糖耐量正常、糖耐量低减至糖尿病,随着糖代谢异常的加重,颈动脉内膜中层逐渐增厚、血NO逐渐降低、CRP逐渐升高(P<0.05或P<0.01)。结论糖代谢异常早期即有血管内皮损伤、炎症反应等变化,并参与了糖尿病动脉硬化的整个进程,因此早期控制血糖、稳定血管内皮损伤、抑制炎症反应,对于延缓、减少糖尿病晚期动脉硬化等并发症具有重要的作用。

The change and significance of blood nitrie oxide, c-reactive protein and their relationsip to carotid intimal-medial thickness in prediabetic and diabetic patients

Objective To investigate the change of blood nitrie oxide(NO)and c-reactive protein(CRP)in glucose tolerance(NGT),impaired glucose tolerance(IGT)and type 2 diabetes mellitus(DM)patients,and their relationship to early diabetic atherosclerosis:carotid intimal-medial thickness(IMT).Methods The level of blood NO and CRP in 90 subjects(of them 30 with NGT,30 IGT and 30 DM)was measured by biochemistry and their carotid IMT by ultrasonics.Results From NGT,IGT to DM,the carotid IMT was increased gradually,whereas the level of blood NO decreased and CRP increased respectively(P<0.05 or P<0.01).Conclusion Vascular endothelia damage and inflammative change play an important role in the early stage of diabetic atherosclerosis and its progression.Hence,early conctrol of blood glucose and use of drug to pretect vascular endothelia damage and to reduce inflammation may well retard the diabetic atherosclerosis and prevent its complications.