冠心病合并2型糖尿病患者的血清AGEs与内皮依赖性血管舒张功能关系探讨

目的　探讨冠心病合并 2型糖尿病 (2 - DM)患者内皮依赖性血管舒张功能与血清糖基化终产物(AGEs)水平变化及二者的关系。方法　选择 6 0例冠心病合并 2 - DM患者为治疗组 ,在冠心病综合治疗的基础上给予胰岛素或其他降糖药物控制血糖 ;另选 6 0例查体健康者为对照组。检测两组血清 AGEs、NO水平 ,采用 Jud-kins法进行选择性冠状动脉造影 ,高分辨超声技术检测肱动脉的血管舒张功能。结果　治疗组治疗前后血清AGEs、NO水平及内皮依赖性血管舒张功能均与对照组有明显差异 (P <0 .0 5 ,<0 .0 1) ,且治疗组治疗前后上述指标亦均有明显差异 (P <0 .0 1)。内皮依赖性血管舒张功能减弱程度与血清 AGEs水平呈负相关 (r =- 0 .39,P <0 .0 1) ,血清 NO水平与血清 AGEs水平呈负相关 (r=- 0 .31,P <0 .0 1)。结论　冠心病合并 2 - DM患者内皮依赖性血管舒张功能明显减弱 ,血清 AGEs水平明显升高 ,可能是 AGEs削弱了其内皮依赖性血管舒张功能。长期良好的血糖控制可降低冠心病合并 2 - DM患者血清 AGEs水平 ,增加血液中 NO水平 ,改善其内皮依赖性血管舒张功能

Study of serum advanced glycation endproducts and endothelium-dependent vasodilation function in patients both with coronary artery disease and type 2 diabetes

Objective To investigate the changes of endothelium-dependent vasodilation function and serum advanced glycation endproducts(AGEs) concentrations,and to evaluate the relationship between them in patients both with coronary artery disease and type 2 diabetes.Methods 60 patients both with coronary artery disease and type 2 diabetes(patients group) and 60 healthy nondiabetic subjects (control group) were recruited.Serum AGEs were measured with fluorescence spectroscopy.Endothelium-dependent and -independent vasodilation function of the brachial artery was measured with high-resolution vascular ultrasound.All patients underwent coronary angiography(CAG) and were treated with insulin or other antidiabetic agent for 3 months.Results There were significantly differences between patients group and control group in serum AGEs levels,serum NO levels,and endothelium-dependent vasodilation function before and after treatment (P<0.05,<0.01).Compared with the levels before treatment,the serum AGEs levels,serum NO levels,and endothelium-dependent vasodilation function were markedly changed after treatment in patients group(P<0.01).On univariate analysis of all subjects,endothelium-dependent function vasodilation correlated with serum AGEs levels(r=-0.39,P<0.01).Serum NO levels were also correlated with serum AGEs levels(r=-0.31,P<0.01).Conclusion Endothelium-dependent vasodilation function is impaired and serum AGEs concentration is increased in patients both with coronary artery disease and type 2 diabetes.Impaired endothelium-dependent vasodilation may be caused by increased serum AGEs.And long-term glycemic control can decrease serum AGEs level,increase serum NO level,and improve vascular endothelial dysfunction.