糖尿病肢体动脉闭塞症血管舒张功能与血浆内皮素-1的变化

Relationship between the vasodilation function and plasma ET-1 in patients with diabetic limb arterial obliteration

目的探讨糖尿病肢体动脉闭塞症患者血管舒张功能与血浆内皮素-1(ET-1)的变化及其相互关系。方法60例糖尿病肢体动脉闭塞症患者按不同病程分为一期组、二期组和三期组各20例,同时纳入20例正常对照者,采用高分辨率超声检测内皮依赖性(EDD)和非内皮依赖性(EID)血管舒张功能,并测定了ET-1的浓度变化。各组间进行分析比较。结果糖尿病肢体动脉闭塞症患者的EDD较对照组明显降低,且随病变的进程逐渐加重,即三期组<二期组<一期组(P<0.05或P<0.01);三期组患者的EID也降低,与其余各组比较,差异有显著意义(P<0.05或P<0.01)。患者血浆ET-1水平高于对照组,且随病变进程而加重,即三期组>二期组>一期组(P<0.05或P<0.01)。经单因素相关分析,EDD与ET-1水平呈负相关(r=-0.59,P<0.05)。结论糖尿病肢体动脉闭塞症患者存在血管舒张功能障碍,并与ET-1增高有关。

Objective To investigate the changes of vasodihtion function, plasma endothelin-1 （ ET- 1 ） and their inter-relationship in patients with diabetic limb arterial obliteration （DLAO）. Methods The endothelium-dependent dilation （EDD） and endothelium-independentdilation （EID） were measured by high resolution ultrasound in 60 patients with DLAO （observation group）and 20 healthy subjects （control group）. 60 patients were divided into three groups according to different stages （20 eases of lst stage,20 cases of 2nd stage and 20 cases of 3rd stage）. The changes of ET-1 were also be ohserved.Results EDD of the brachial artery in patients with DIAO was reduced significantly as compared with that in control group, and EDD had significant changes in different stages, as 3rd stage group〈 2nd stage group〈 1st stage group （ P 〈0.05 or P 〈 0.01）.EID of the brachial artery in patients at 3rd stage was also significantly lower than those in other goups（ P 〈 0.05 or P 〈 0.01 ） .ET-1 levels in all patients were higher than those in control goup,and with the progression of disease,the level of ET-1 increased as 3rd stage group 〉 2nd stage group〉 1st stage group （ P 〈0.05 P 〈 0.01）,whih linear correlation analysis showed that EDD was enrrelated negatively with the levels OfET-1 （ r = -0.59, P 〈0.05）.Conclusion There exist vasodilation function disorders in patients with DLAO,which is correlated with the increase of ET-1.