糖尿病患者血液流变学与甲襞微循环改变之间的关系

The relationship between hemorrheology and nailfold microcircu-lation in diabetics

目的：探讨糖尿病（ＤＭ）患者血液流变学与微循环改变的关系及其影响因素。方法：测定了３５例ＤＭ患者的血液流变学、甲襞微循环和部分生化指标，同时用４４例正常人作对照。结果：①非胰岛素依赖性糖尿病（ＮＩＤＤＭ）组各项粘度指标显著增高（Ｐ＜０．０１）；②各ＤＭ组及不同并发症亚组红细胞刚性和微循环各流态指标显著异常（Ｐ＜０．０５～０．０１）；③ＮＩＤＤＭ组及多数慢性并发症亚组微循环形态和管周指标显著改变（Ｐ＜０．０５～０．０１）；④ＮＩＤＤＭ组纤维蛋白原和总胆固醇明显高于对照组和胰岛素依赖性糖尿病（ＩＤＤＭ）组（Ｐ均＜０．０５）；⑤直线相关分析显示上述主要指标间有一定的相关性。结论：ＤＭ患者血液流变学异常和微血管病变有共同的发生机制并导致微循环障碍。

Objective:To investigate the relationship-between hemorrheology and microcirculation in diabet-ics.Methods:We determined the parameters of hemorrheology and nailfold microcirculation and some of thebiochemical parameters of 35 diabetics and 44 healthy controls. Results:(1) All the parameters of the bloodviscosity in NIDDM are significantly higher than those in control group (P<0. 01); (2)The RBC rigidity in-dex and all parameters of bloodstream of microcirculation in each DM group are significantly higher or lowerthan those in controls(P<0.05～0.01 );(3)The microcirculatory and pericapillary parameters in NIDDMgroup and most subgroups of the diabetics with chronic complications are higher or lower than controls (P<0. 05～0. 01);(4) The fibrinogen and TG levels in NIDDM are significantly higher than controls and IDDMgroup(P< 0.05);(5) There is a significant correlationship between the major parameters of these areas.Conclusion:The changes of hemorrheology and microangiopathy may be the cause of the disorders of micro-circulation in diabetics.