糖耐量低减患者颈动脉内-中膜厚度与肱动脉血管内皮舒张功能的超声研究

Study on intima-media thickness of carotid and endothelium dilation function of the brachial artery in patiens with impaired glucose tolerance

目的应用高频超声检查糖耐量低减(IGT)患者颈动脉内-中膜厚度(IMT)及肱动脉血管内皮舒张功能,对IGT患者早期动脉粥样硬化病变进行评估。方法高频超声检查50例IGT患者和50例正常对照组颈动脉IMT及粥样硬化斑块,同时检测肱动脉血流介导的内皮依赖性(EDD)及非内皮依赖性(EID)舒张功能,并进行对比分析。结果IGT患者颈动脉IMT及斑块发生率均高于正常对照组(P≤0.01),IGT组内皮依赖性血管舒张功能较正常对照组减低(P<0.01);硝酸甘油介导的非内皮依赖性血管舒张功能两组间无差异(P>0.05)。IGT组颈动脉IMT与年龄,体重指数及2 h血糖、总胆固醇及低密度脂蛋白胆固醇水平,均呈正相关(P<0.01),与EDD呈负相关(P<0.01);经多元逐步回归,年龄和EDD是颈动脉IMT增厚的独立危险因素。结论高频超声检查IGT患者颈动脉IMT和肱动脉内皮舒张功能,可提供干预治疗及预防心血管疾病的客观依据。

Objective To examine the IMT of carotid and endothelium dilation function of brachial artery in patients with impaired glucose tolerance （IGT） by high - frequency ultrasound, and to evaluate early atheromatosis in patients with IGT. Methods Fifty patients with IGT and 50 normal subjects （control group）were enrolled in this study. Their IMT of carotid artery and atheroselerotic plaques were examined by high - frequency ultrasound, and the endolhelium - dependent dilation function （EDD） and endothelium - independent dilation function of brachial artery were measured at the same time, the results was analyzed and compared. Results The incidence of carotid artery IMT and plaques in IGT group was higher than that in control group （P≤0.01）, EDD in IGT group was lower than that in control group （P 〈 0.01 ）, there was no significant difference of nitroglycerin - mediated EID in the two groups （ P 〉 0.05 ）. There was positive correlation between carotid - IMT and age, BMI, 2hPG, TC, LDL - C in IGT group （P 〈 0.01 ）, while there was negative correlation between carotid - IMT and EDD% （ P 〈 0.01 ）. Multiple regression analysis showed that age and EDD were independent risk factors for carotid - IMT. Conclusion High- frequency ultrasound examination of carotid IMT and endothelium dilation funtion in patients with IGT can provide objective information in treatment and prevention of cardiovascular disease.