糖尿病患者甲襞微循环与大血管病变的关系研究

目的 :研究糖尿病患者甲襞微循环与大血管病变之间的关系。方法 :选择糖尿病患者 69例及正常对照 3 0例 ,并将糖尿病患者分为甲襞微循环正常组 3 1例和甲襞微循环异常组 3 8例 ,分别检测甲襞微循环、计算微循环的形态积分、流态积分、袢积分及总积分 ,同时检测血浆甘油三酯 (TG)、胆固醇 (CH)、载脂蛋白A1 (apoA1 )、载脂蛋白B(apoB)、糖化血红蛋白 (HbA1 c)、血浆胰岛素及双下肢血管多普勒 ,分析糖尿病时甲襞微循环的变化特点以及和上述临床指标间的关系。结果 :糖尿病甲襞微循环异常组微循环的形态积分、流态积分、袢积分和总积分均明显高于糖尿病甲襞微循环正常组。糖尿病甲襞微循环异常组的流态积分与 12 0min血糖间存在显著正相关 (r =0 .681,P <0 .0 0 1)。糖尿病甲襞微循环异常组股动脉内膜粥样硬化的发生率明显高于糖尿病甲襞微循环正常组 (P <0 .0 5 )。结论 :糖尿病时甲襞微循环异常与大血管病变之间存在密切相关性 ,糖尿病甲襞微循环的异常可以提示糖尿病大血管病变的存在。

The Study of Relationship Between Nailfold Microcirculation and Lesion of Large Vessels in Diabetes Mellitus

Objective:To study the relationship between nailfold microcirculation and lesion of large vessels in diabetes mellitus. Methods:69 patients with diabetes mellitus and 30 normal controls were selected as object of study and the former were divided into normal nailfold microcirculation group (up to 31 ) and abnormal nailfold microcirculation group(up to 38). Nailfold microcirculation, triglycerides, Cholesterol, apoprotein A1, apoprotein B, HbA1c, plasma insulin and Doppler of Both lower extremities were detected and the morphological, hemodynamical, perivascular and total score value were calculated in all objects. We analyzed the changes of nailfold microcirculation and relationship between those and above mentioned clinical index. Results:The morphological, hemodynamical, perivascular and total score value in abnormal nailfold microcirculation group were obviously more than those in normal nailfold microcirculation group. There was significantly positive correlation between hemodynamical score and two-hour plasma glucose in abnormal nailfold microcirculation group( r =0.681, P <0.001). The incidence of Arteriosclerosis of Tunica intima of femoral artery in abnormal nailfold microcirculation group was significantly more than that in normal nailfold microcirculation group( P <0.05). Conclusion:There was closely correlation between the abnormality of nailfold microcirculation and lesion of large vessels. The abnormality of nailfold microcirculation in diabetes mellitus can indicate the existence of lesion of large vessels.