糖尿病患者肠系膜小动脉对缩血管物质的反应性变化

Changed responses of small mesenteric arteries to vasoconstrictors in diabetic patients

目的探讨糖尿病患者肠系膜小动脉对缩血管物质的反应。方法取剖腹手术时糖尿病患者肠系膜小动脉作为观察组,以非糖尿病患者的肠系膜相应部位小动脉血管作为对照,通过BL-420张力描记系统记录两组动脉血管对于K+,NA,5-HT,S6c及ET-1等5种缩血管受体激动剂反应的量效曲线。结果 K+引起观察组与对照组的收缩张力分别为(5.39±1.19)mN和(2.92±0.78)mN(P<0.01);观察组对于NA收缩的Emax和pEC50分别为(162±10)%,6.57±0.14,对照组为(97±19)%和5.94±0.17,组间差异有统计学意义(P<0.01)。5-HT引起Emax和pEC50观察组为(41±14)%,6.21±0.19,对照组为(3±1)%和7.49±0.21,差异有统计学意义(P<0.01);S6c对于对照组不引起明显收缩,但对于观察组的Emax和pEC50分别为(60±14)%和7.81±0.76(P<0.01);观察组对较低浓度(<10-11mmol/L)的ET-1反应性高于对照组(P<0.01),较高浓度时反应性稍低于对照组(P>0.05)。结论糖尿病患者肠系膜小动脉对于K+及α受体,5-HT,ETB等缩血管受体激动剂的反应性明显高于非糖尿病患者,可能是由于对受体结合力增强所致。这可能是导致糖尿病患者腹部手术后胃肠道功能恢复延迟,相应并发症增多的重要因素之一。

Objective To observe the responses of small mesenteric arteries to vasoconstrictors in diabetic patients.Methods The small mesenteric arteries in patients with diabetes undergoing abdominal surgeries were obtained and used as the observation group,and the corresponding small mesenteric arteries of nondiabetic patients were obtained and used as control group.The dose-effect curves of small mesenteric arteries response to vasoconstrictors including K＋,NA,5-HT,S6c and ET-1 were recorded using BL-420 tension trace system.Results The vascular tension induced by K＋ in the observation group and the control group was（5.39±1.19） mN and（2.92±0.78） mN,respectively（P〈0.01）;Maximal contraction（Emax） and pEC50 induced by NA in observation group was（162±10）% and（6.57±0.14）,and in control group was（97±19）% and 5.94±0.17（P〈0.01）,respectively.Emax and pEC50 induced by 5-HT in observation group and control group was（41±14）%,（6.21±0.19） mN,and（3±1）%,（7.49±0.21） mN respectively（P〈0.01）;Emax and pEC50 of observation group induced by S6c was（60±14）% and（7.81±0.76） mN;no response to S6c was noted in the control group（P〈0.01）.The response of the observation group to lower concentration ET-1（10-11 mmol/L） was higher than that of the control group（P〈0.01）,and to higher concentration ET-1 was lower than that of the control group（P〉0.05）.Conclusions The response of small mesenteric arteries to vasoconstrictors in diabetic patients is higher than that in the nondiabetic individuals,which is probably due to increased receptor-binding affinity of the α-receptor,5-HT and ETB.