高血压合并2型糖尿病患者血浆脂联素与血管内皮功能相关性研究

目的：探讨高血压（EH）合并2型糖尿病（T2DM）患者血浆Adiponectin水平与血管内皮功能的关系。方法：选取研究对象105例根据标准分为正常对照组（NC组）、原发性高血压组（EH组）、高血压合并2型糖尿病组（EH＋T2DM组）,各组分别测定脂联素（Adiponectin）、血栓调节蛋白（Tm）、一氧化氮（NO）,并进行对比及相关分析。结果：与NC组比较,EH＋T2DM组和EH组Tm明显增高（P〈0.05）,血浆Adiponectin和NO明显降低（P〈0.05）。与EH组比较,EH＋T2DM组的Tm明显增高,血浆Adiponectin和NO明显降低（P〈0.05）。EH＋T2DM组血浆Adiponectin水平与Tm呈显著负相关（r=-0.353、P〈0.05）;与NO呈显著正相关（r=0.279,P〈0.05）;Tm与NO呈明显负相关（r=-0.319,P〈0.05）。血浆Adiponectin和NO是平均动脉压独立的影响因素。结论：EH患者体内存在Adiponectin、NO和Tm的异常表达,合并T2DM患者更为显著。血浆Adiponectin可能通过调节血管内皮功能进而在EH、EH合并T2DM的发病机制中具有重要作用,此为早期干预EH＋T2DM提供了理论依据。

Relationship between plasma adiponectin and vascular endothelial function in patients with essential hypertension and type 2 diabetes mellitus

Objective： To investigate the relationship between plasma adiponectin levels and vascular endothelial function in patients with essential hypertension and type 2 diabetes mellitus.Methods： 32 subjects with normal control（NC）,35 patients with essential hypertension（EH） and 38 patients with EH complicated by T2DM（EH＋T2DM） participated in this study.Fasting plasma adiponectin,thrombomodulin（Tm） and nitric oxide（NO） levels were measured by enzyme-linked immunosorbent assay（ELISA）.Comparative and related analysis among them was also conducted.Results： Patients with EH and EH complicated by T2DM had significantly higher Tm（P0.05） and lower plasma adiponectin and NO levels than that of NC group（P0.05）;Patients with EH complicated by T2DM had significantly higher Tm levels and lower plasma adiponectin and NO levels than that of EH group（P0.05）.Fasting plasma adiponectin levels were correlated negatively with Tm in patients with EH complicated by T2DM（r=-0.353、 P0.05）,and positively with NO（r=0.279,P0.05）;Tm was positively correlated with NO（r=-0.319,P0.05）.Plasma adiponectin and NO levels were independent related factors in influencing mean arterial pressure.Conclusion： The abnormal expression of Adiponectin,NO and Tm exists in patients with EH,especially in patients with EH complicated by T2DM.Plasma adiponectin may be related to EH and EH complicated by T2DM through regulation of vascular endothelial function,which was provided evidence for early interventions.