糖尿病患者血管内皮舒张功能的超声研究

目的 :研究 型糖尿病 (non-insulin-dependent diabetes mellitus,NIDDM)患者尿蛋白排泄量与血管内皮舒张功能损伤的关系。方法 :采用高分辨率超声测定伴有不同程度蛋白尿的 型糖尿病患者血流介导的肱动脉内皮依赖性血管舒张和硝酸甘油介导的非内皮依赖性血管舒张。结果 :糖尿病尿蛋白正常组、微量组、大量组内皮依赖性血管舒张功能较正常对照组降低 (P<0 .0 0 1) ;大量蛋白尿组较尿蛋白正常组降低 (P<0 .0 5) ;硝酸甘油介导的非内皮依赖性血管舒张各组间无差异 (P>0 .0 5)。多因素线性相关性分析 ,糖尿病患者血管内皮依赖性舒张功能损伤和尿蛋白排泄量、糖化血红蛋白、血浆甘油三酯呈负相关。结论 :糖尿病患者血管内皮舒张功能损伤早于蛋白尿出现

Ultrasonographic Study of Endothelial Function in Patients with Diabetes

Objective:To investigate the associat io ns between urinary albumin excretion and endothelial function in patients with n on-insulin-dependent diabetes mellitus (NIDDM).Methods: Using high resolution ultrasound,we measured the dilation during reactive hypera emia (with increased flow causing endothelium-dependent dilatation) and after s ublingual nitroglycerin (NTG,causing endothelium-independent dilation) in 58 su bjects:16 controls without diabetes and 42 diabetes including 15 normoalbuminuri a patients,15 microalbuminuria patients and 12 macrolbuminuria patients.Results:In all three groups of patients with NIDDM,flow-m ediated dilatation (FMD)was decreased significantly compared with the healthy co ntrol group ( P <0 001); FMD in NIDDM patients with macroalbuminuria group w as significantly lower than that in NIDDM with normoalbuminuria( P <0 01); t he dilation by NTG did not differ significantly among the four groups ( P >0 05) Multiple regression analysis showed that endothelial dysfunction was sign ificantly correlated with diabetes urinary albumin excretion (UAE),hemoglobin A 1c (HbA1c)and triglyceride (TG).Conclusions:Before the abnormoalbuminuria,the endothelium - dependent vasodilation in diabetes was reduced and became more serious with incr ease of UAE,HbA1c and TG.