高血压合并2型糖尿病患者动脉弹性与氧化应激和血管内皮功能的相关性

目的 研究高血压合并糖尿病患者肱-踝脉搏波传导速度与血清中丙二醛、超氧化物歧化酶和一氧化氮的相关性,探讨氧化应激、血管内皮功能变化在动脉硬化过程中的作用.方法 研究对象168例分为正常对照组(n=40)、原发性高血压组(n=70)和高血压合并2型糖尿病组(n=58),各组分别用比色法检测血清丙二醛、超氧化物歧化酶和一氧化氮含量,应用动脉硬化自动检测仪测定肱-踝脉搏波传导速度.结果 与对照组比较,原发性高血压组和高血压合并2型糖尿病组中丙二醛水平和肱.踝脉搏波传导速度明显增高(P<0.01),超氧化物歧化酶和一氧化氮水平明显降低(P<0.01);与原发性高血压组比较,高血压合并2型糖尿病组丙二醛水平和肱-踝脉搏波传导速度明显增高(P<0.05),超氧化物歧化酶和一氧化氮水平降低(P<0.05).相关分析显示肱-踝脉搏波传导速度与年龄、收缩压、舒张压、胆固醇、空腹血糖、高敏C反应蛋白和丙二醛呈正相关(相关系数r分别为0.418、0.672、0.469、0.179、0.392、0.277和0.571,均P<0.05),与超氧化物歧化酶和一氧化氮呈负相关(r分别为-0.438和-0.571,均P<0.05).多元逐步回归分析显示收缩压、丙二醛、空腹血糖和年龄是肱-踝脉搏波传导速度的独立危险因素.结论 高血压合并糖尿病患者动脉弹性明显减弱,且与体内氧化应激增强和血管内皮功能损伤有关,提示氧化应激和血管内皮功能在动脉硬化过程中起重要作用.

The Relationship between Arterial Elasticity and Oxidative Stress,Endothelial Function in Patients with Hypertension Co-existed with Type 2 Diabetes Mellitus

Aim To study the relationship between brachial-ankle pulse wave velocity (BaPWV) and serum ma-lonyldialdehyde(MDA), superoxide dismutase (SOD) and nitric oxide (NO) in patients with hypertension co-existed with type 2 diabetes mellitus, and to investigate the effects of oxidative stress and vascular endothelial function on the develop-ment of arteriosclerosis. Methods 168 patients were devidid into normal control (n = 40), hypertension (n = 70) and hypertension complicated with type 2 diabetes mellitus group (n = 58). The serum NO, MDA and SOD were measured by colorimetric method respectively, and BaPWV were recorded by an automatic arterial stiffness measurement device. Results Compared with the control group, serum MDA, BaPWV were significantly higher and SOD, NO was lower (P < 0. 05) in the hypertension group and the hypertension complicated with type 2 diabetes mellitus group. Compared with the hypertension group, serum MDA, BaPWV were significantly higher and SOD, NO was lower (P < 0. 05) in the hyper-tension complicated with type 2 diabetes mellitus group. Correlation analysis showed that BaPWV was positively correlated with age, systolic blood pressure, dilated blood pressure, cholesterol, fasting blood glucose (FBG), high-sensitivity C-re-active protein (hs-CRP), serum MDA (r=0.418, 0.672, 0.469, 0.179, 0.392, 0.277, 0.571, all P<0. 05) , and was negatively correlated with serum SOD and NO (r = - 0.438, - 0.571, all P < 0.05). The analysis of multiple step-wise regression showed that BaPWV was positively correlated with systolic blood pressure, MDA, FBG and age. Con-clusion Arterial elasticity significantly decreased and was correlated with increase of oxidative stress and reduction of vas-cular endothelial function in patients with hypertension complicated with type 2 diabetes mellitus, suggesting that oxidative stress and endothelial function plays an important role in the development of arteriosclerosis.