糖耐量减低患者联合干预治疗前后内皮依赖性血管舒张功能的变化

目的为了探讨糖耐量减低(IGT)患者联合干预治疗前后内皮功能的变化。方法选择28例IGT患者,和年龄、性别匹配的健康个体25人。IGT患者采用控制饮食、规则的有氧运动及口服二甲双胍联合干预治疗12周。采用高分辨血管外超声法检测肱动脉内皮依赖性血管舒张功能和内皮非依赖性血管舒张功能。结果IGT患者干预治疗前内皮依赖性血管舒张功能为3.50%,明显低于对照组的4.68%(P<0.05)。多元逐步回归分析结果显示,内皮依赖性血管舒张功能与年龄、LDL-C、Lp(a)、HbA1c、FPG及2hPG呈负相关(P<0.001)。经联合干预治疗12周后,内皮依赖性血管舒张功能明显增高,达到4.17%,明显高于IGT患者干预治疗前(P<0.05)。Spearman分析结果显示,治疗前后内皮依赖性血管舒张功能的变化与FBG、2hBG、LDL-C、HbA1c的变化呈负相关(P<0.05)。结论IGT患者内皮依赖性血管舒张功能降低。联合干预治疗可改善血管内皮功能。

Changes of endothelium-dependent arterial dilation before and after combined intervention therapy in impaired glucose tolerant patients

Objective To study the alteration of endothelium-dependent arterial dilation beforeand after combined intervention therapy in impaired glucose tolerant (IGT) patients.Methods Twenty-eight IGTpatients and 25 healthy individuals were selected randomly,and high resolution ultrasound wasperformed to measure changes in brachial artery diameter at rest,after reactive hyperemia (endothelium-dependent dilation) and after sublingual glyceryltrinitrate (an endothelium-independent dilator).After 12weeks of combined intervention therapy (including diabetic diet, regular aerobic exercise,and metform-in),vascular studies were repeated.Results At baseline,the flow-mediated arterial dilation in IGTgroupwas 3.50%,which was significantly lower than that in control (4.68%)(P<0.05).By multiple stepwiseregression analysis,reduced flow-mediated arterial dilation was associated with age,LDL-C,Lp(a),FPG,2h PG,HbA1c in IGTpatients at baseline (P<0.001).After combined intervention therapy,endothelium-dependent arterial dilation increased from 3.50% to 4.17% in IGT patients (P<0.05).The absolutechange in endothelium-dependent arterial dilation showed a significant negative correlation with the chan-ges in FBG,2h BG,LDL-C,HbA1c (P<0.05).Conclusion The endothelium-dependent arterial dila-tion is decreased in IGTpatients,and combined intervention therapy can improve endothelial function sig-nificantly.