糖化血红蛋白及高血压对2型糖尿病患者血管内皮功能的影响

An evaluation of hemoglobin A1c and blood pressure on endothelial function in patients diagnosed with type2 diabetes

目的评估糖化血红蛋白(HbA1c)和血压对2型糖尿病患者血管内皮功能的影响。方法将82例2型糖尿病患者分成4组:Ⅰ组16例,糖尿病者HbA1c<8.0%不伴有高血压,Ⅱ组21例,糖尿病者HbA1c<8.0%同时合并高血压,Ⅲ组22例,糖尿病者HbA1c>8.0%不伴有高血压,Ⅳ组25例,糖尿病者HbA1c>8.0%同时合并高血压。应用彩色多普勒对四组之间的肱动脉进行检测,观察静息状态下、反应性充血后及含服硝酸甘油后的内径变化。结果Ⅲ组、Ⅳ组肱动脉反应性充血前后的内径变化率明显小于Ⅰ组和Ⅱ组(P<0.05)。含硝酸甘油后的肱动脉内径变化率,Ⅳ组明显小于Ⅰ组、Ⅱ组(P<0.05)。结论糖尿病患者内皮依赖性血管舒张功能受损,糖化血红蛋白是重要的影响因素;在糖尿病的基础上同时合并高血压,将进一步导致非内皮依赖性血管舒张功能受损。

Objective To evaluate the effect of hemoglobin Alc （HbAlc） and blood pressure on the endothelial function in patients diagnosed with type2 diabetes. Methods Eighty-two type 2 diabetic patients were divided into four groups （group Ⅰ ： HbA1 c under 8 % and no hypertension; group Ⅱ ： HbA1 c under 8 % with hypertension; group Ⅲ ： HbAlc above 8% with no hypertension; group Ⅳ ： HbAlc above 8% with hypertension）. The diameter of the brachial artery was measured by color Doppler ultrasound at rest, after reaction hyperemia and after sublingual nitroglycerin administration respectively. Results The percent of diameter change of the brachial artery in response to reactive hyperemia was significantly lower in group m and group Ⅳ than that in group Ⅰ and group Ⅱ （ P 〈 0.05）. The percent of diameter change of brachial artery after sublingual nitroglycerin administration was significantly lower in group Ⅳ than that in the other three groups（ P〈 0.05）. Conclusion The endothelium-dependent vasodilatation is impaired in type2 diabetic patients and impairs further when combined with hypertension. HbA1 c might be a risk factor of impaired endothelium-dependent vasodilatation in type 2 diabetic patients.