原发性高血压合并2型糖尿病与肱动脉血流介导的血管舒张功能及颈动脉内-中膜厚度关系的研究

Relationship of pulse pressure with brachial artery flow-mediated dilatation function and carotid intima-media thickness in patients with Hypertension Co-existed with type 2 Diabetes

目的研究原发性高血压合并2型糖尿病患者与肱动脉血流介导的血管舒张功能(FMD)及颈动脉内-中膜厚度(IMT)的关系。方法研究对象82例根据标准分为正常对照组、原发性高血压(EH)组、高血压合并2型糖尿病(EH+2DM)组。用高分辨率超声检测各组颈动脉IMT、肱动脉FMD并进行统计学分析。结果各组肱动脉FMD变化:正常对照组为(8.97±5.05)%,EH组为(5.51±4.02)%,EH+2DM组为(2.19±2.87)%,3组间两两比较均有极显著性差异(P<0.01)。FMD与其他因素的相关性分析:FMD与收缩压、血糖呈负相关(r=-0.34,P<0.05;r=-0.37,P<0.05)。各组颈动脉IMT:与正常对照组[(0.73±0.34)mm]比较,EH组[(1.05±0.26)mm]和EH+2DM组[(1.17±0.28)mm],均有极显著性差异(P=0.01);且EH组与EH+2DM组比较,有显著性差异(P<0.05)。结论血糖增高的高血压患者颈动脉内-中膜厚度增厚,EH+2DM患者血管内皮功能进一步减退。

Objective This study was sought to investigate whether pulse pressure is associated with artery flow-mediated dilatation （FMD）function and carotid intima-media thickness（IMT） in a group of hypertension patients.Methods eighty one subjects were grouped into normal control,hypertension and hypertension complicated with type 2 diabetes mellitus group. Endothelial dependent flow mediated dilataion （FMD） and carotid arterial intima-media thickness（IMT） were determined by high-resolution vascular ultrasound.Results There was a significant difference in brachial artery flow-mediated dilation （FMD） between groups（5.45±4.08）% ,（2.21±2.97）% and（8.85±5.08）%P〈0.01. Systolic pressure,blood glucose was negatively correlated with FMD （r=-0.34,P〈0.05;r=-0.37,P〈0.05）. There was a significant difference in IMT between groups（1.00±0.21）mm,（1.18±0.27）mm and（0.74±0.24）mm,P〈0.01.Conclusion In hypertension patients with increased blood glucose tend to have an increased IMT ,endothelial function were seriously impaired in patients with hypertension complicated with type 2 diabetes mellitus.