糖尿病肢体动脉闭塞症血管张力因素的变化特点

Characteristic Changes of Vascular Tension Factors in Diabetic Arterial Occlusion of Lower Extremities

目的研究糖尿病肢体动脉闭塞症不同病变时期 ,血管收缩因素内皮素 1(endothelin 1,ET 1)、血栓素A2 (thromboxaneA2 ,TXA2 )和血管舒张因素一氧化氮 (nitricoxide,NO)、前列环素 (prostacyclin ,PGI2 )的变化特点 ,初步探讨这些变化的临床意义。方法 4 0例患者中Ⅱ期患者 15例 ,Ⅲ期患者 2 5例 ,并设健康对照组。应用放射免疫方法测定血浆ET 1、NO、血栓素B2 (thromboxaneB2 ,TXB2 )和 6 酮 前列腺素F1α(6 keto PGF1α)浓度。结果 (1)病变各组的ET 1、TXB2 水平均高于健康对照组 (P <0 0 1,P <0 0 5 ) ;Ⅲ期组高于Ⅱ期组 ,且差异有显著性 (P <0 0 5 )。 (2 )病变各组NO、6 keto PGF1α水平均低于健康对照组 (P<0 0 1) ,病变组之间差异无显著性 (P >0 0 5 )。结论糖尿病肢体动脉闭塞症存在血管张力因素的变化 ,血管收缩因素明显增强 ,血管舒张因素明显降低 ,而且这一变化在不同的病变时期也表现出不同的特点 ,Ⅲ期患者血管收缩因素和血栓形成因素明显高于Ⅱ期患者 ,而血管舒张因素的受损程度两者无明显差异。

Objective To study the change of vascular tension factors (VTF), including vascular contractile factors as endothelin 1 (ET 1), thromboxane A 2 (TXA 2) and vascular dilatory factors as nitric oxide (NO), prostacyclin (PGI 2), in different stage of peripheral diabetic arterial occlusion (PDAO), and to preliminarily explore the clinical significance of these changes. Methods VTF in 40 diabetic patients, 15 of 2nd stage and 25 of 3rd stage, were observed by measuring level of ET 1, NO, TXB 2 and 6 keto PGF 1α in blood plasma with RIA assay. Results (1) ET 1 and TXB 2 levels in all patients were higher than those in control (P<0 05 and P<0 01), those in patients of 3rd stage was higher than those of 2nd stage, showing significant difference (P<0 05). (2) NO and 6 keto PGF 1α levels in all patients was lower than those in control, but showed no significant difference between patients of various stages (P>0 05). Conclusion There are changes of VTF in patients with PDAO, manifesting as increase of vascular contractive factors and decrease of vascular dilative factor. The changes are different in various stages, the vascular contractive and thrombotic factors in patients of 3rd stage are higher than those in patients of 2nd stage, but the injury on vascular dilative factors in the two stages showed insignificant difference.