糖尿病合并冠状动脉粥样硬化性心脏病患者与血管内皮功能的关系

目的:探讨糖尿病合并冠状动脉粥样硬化性心脏病患者与血管内皮功能的关系.方法:将2017年3月-2018年3月在南方医科大学顺德医院附属杏坛医院心内科治疗的50例糖尿病合并冠状动脉粥样硬化性心脏病患者作为观察组,将同期50例单纯冠状动脉粥样硬化性心脏病患者作为对照组,比较两组的血管内皮功能各血清指标及血管扩张功能(Flow-Mediated Dilatation,FMD)、硝酸甘油诱发内皮独立的血管舒张幅度(Nitroglycerine-induced Vasodilation,NID)变化、影响FMD因素分析.结果:观察组内皮素-1(Endothelin-1,ET-1)、NID水平明显高于对照组,而脂联素(Adiponectin,APN)、一氧化氮(Nitric Oxide,NO)、FMD水平明显低于对照组(P<0.05);多元回归分析显示,FMD与APN、NO呈正相关(r=0.679,0.432,P<0.05),FMD与ET-1、GLU呈负相关(r=-0.497,-0.274,P<0.05).结论:糖尿病合并冠状动脉粥样硬化性心脏病患者存在明显血管内皮功能紊乱,FMD受APN、NO、ET-1、空腹血糖(Glucose,GLU)影响,临床可通过升高APN、NO,降低ET-1、GLU来改善FMD,从而抑制病情进展.

Relationship between vascular endothelial function and diabetes mellitus complicated with coronary heart disease

Objective:To explore the relationship between vascular endothelial function and diabetes mellitus complicated with coronary heart disease.Methods:Fifty patients with diabetes mellitus complicated with coronary heart disease treated in Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University from March 2017 to March 2018 were selected as the observation group and 50 patients with simple coronary heart disease as the control group.The changes of serum indexes of vascular endothelial function and the degree of increase of internal diameter of reactive hyperemia brachial artery induced by nitroglycerin(FMD)were compared between the two groups,and the factors affecting FMD were analyzed.Results:The level of ET-1,NID in the observation group was significantly higher than that in the control group,but the level of APN,NO,FMD was significantly lower than that in the control group(P<0.05),and multiple regression analysis showed that there was a positive correlation between FMD and APN,NO(r=0.679,0.432,P<0.05).There was a negative correlation between FMD and ET-1,GLU(r=-0.497,-0.274,P<0.05).Conclusion:There is obvious vascular endothelial dysfunction in patients with diabetes mellitus complicated with coronary heart disease.FMD is affected by APN,NO,ET-1,GLU.FMD can be improved by increasing APN,NO,and decreasing ET-1,GLU,so as to inhibit the progress of the disease.