不同血糖水平糖尿病患者动脉弹性指数的变化

Arterial Compliances in Diabetes Patients with Different Plasma Glucose Levels

目的观察不同血糖水平糖尿病患者动脉弹性指数的变化及其与血压、糖代谢等因素的关系。方法选取空腹血糖>5·6mmol/L的糖尿病患者共313人,男性176人,女性137人,年龄(52·9±11·5)岁。根据1999年WHO糖尿病诊断标准,将所有受试者按照口服葡萄糖耐量试验(OGTT)结果分为4组:正常血糖组(n=86)、空腹血糖受损组(IFG,n=36)、糖耐量减低组(IGT,n=45)和糖尿病组(n=146)。采用美国HDI公司CVProfilorTMDO-2020型动脉弹性功能测定仪系统测量血管弹性。结果1)校正年龄后,与血糖正常组、IFG组、IGT组相比,糖尿病组大动脉弹性指数(C1)、小动脉弹性指数(C2)明显下降。血糖正常组、IFG组、IGT组3组间的C1、C2差异无统计学意义。2)多元逐步回归分析显示:C1与脉压、脉率、年龄、餐后2h血糖负相关。C2与年龄、餐后2h血糖、平均动脉压负相关。结论1)糖尿病患者动脉弹性指数降低,而糖尿病发病前状态(IFG,IGT)未见动脉弹性的异常。糖尿病对血管弹性的影响独立于血压水平。2)脉压对C1的影响较大,而餐后2h血糖对C2的影响大于血压的影响。

Objective To investigate the changes of large and small artery compliances in patients with dif- ferent plasma glucose levels and the relationship between arterial compliance and blood pressure, plasma glucose. Methods This study was conducted in 313 patients, 176 males and 137 females, 52.9±11.5 years old, fasting glycaemia were 〉5.6 mmol/L. Patients were classified into 4 groups： normal plasma glucose group（n=86）, impaired fasting glucose group （IFG, n= 36） , impaired glucose tolerance group （IGT, n=45） , DM group（ n= 146）. Large arterial compliance （C1） and small arterial compliance （C2） were measured by CVProfilor TMDO- 2020 cardiovascular profiling system. Results 1 ）Compared with patients of normal blood glucose, IFG, IGT groups, C1 and C2 were significantly decreased in DM group. No significant differences in Cl and C2 were found among normal blood glucose, IFG and IGT groups. 2）Multivariable regression analysis revealed C1 related nega- tively with pulse pressure, pulse rate, age, 2 h plasma glucose; C2 related negatively with age, 2 h plasma glucose （OGTT） and mean arterial pressure. Conclusion 1） Arterial compliances were normal in pre-diabetic period, but were decreased significantly in DM patients. 2） Pulse pressure was the main determinant factor for C1 , whereas, the 2 h plasma glucose seems to have greater impact on C2 than that by blood pressure.