2型糖尿病合并血管并发症患者一氧化氮和内皮素水平评价

Evaluation of levels of nitric oxide and endothelin in type 2 diabetes patients with angiopathy

目的探讨合并血管并发症的2型糖尿病患者血清一氧化氮(nitric oxide,NO)和内皮素(endothelin,ET)水平的变化,并分析各危险因素与两者之间的关系。方法入选2型糖尿病患者98例,根据分组条件分为糖尿病合并血管并发症组(A组,49例)和糖尿病无血管并发症组(B组,49例),同期选择年龄、体质指数相匹配的健康对照44例(C组)。所有受试者记录身高、体质量、血压、病程,抽血检测空腹血糖(fasting blood-glucose,FBG)、糖化血红蛋白(hemoglobin A1c,Hb A1c)、血脂各项指标,以及血清NO和ET-1水平。结果与C组比较,A组及B组的NO水平均显著降低[(43.87±12.05)和(53.29±11.75)μmol/L vs(66.08±16.48)μmol/L,P<0.01],而ET-1水平显著升高[(100.25±20.34)和(77.55±14.84)ng/L vs(53.62±8.40)ng/L,P<0.01]。A组NO水平显著低于B组[(43.87±12.05)vs(53.29±11.75)μmol/L,P<0.01],而ET-1水平显著高于B组[(100.25±20.34)vs(77.55±14.84)ng/L,P<0.01]。在糖尿病两组之间,收缩压、舒张压、Hb A1c及病程,A组明显高于B组(P<0.01)。相关分析显示,舒张压、收缩压、空腹血糖、Hb A1c与NO之间存在负相关;HDL-C与NO之间存在正相关。HDL-C与ET-1存在负相关;收缩压、LDL-C、血尿酸、空腹血糖、Hb A1c与ET-1之间存在正相关。结论糖尿病患者血清NO和ET水平明显异常,存在血管内皮功能损伤;有血管并发症者损伤更严重,且与血糖、血压、血脂的控制水平具有相关性。

Objective To investigate the changes in serum levels of nitric oxide（ NO） and endothelin（ ET） in type 2diabetes patients with vascular complications,and to analyze the relationship between these levels and risk factors. Method We selected 98 cases of type 2 diabetes patients. Based on the grouping criteria,the patients were divided into diabetic patients with vascular complications（ group A,49 cases） and those without（ group B,49 cases）. In addition,44 age-and body mass index-matched healthy cases were selected for control（ group C）. Height,weight,blood pressure,duration of diabetes,fasting blood glucose,hemoglobin A1c（ Hb A1c）,blood lipids,and serum levels of NO and ET-1 of all the patients were recorded. Results The NO levels of the two groups with diabetes mellitus were significantly lower than in group C[（ 43. 87 ± 12. 05） and（ 53. 29 ± 11. 75） μmol / L versus（ 66. 08 ± 16. 48） μmol / L,P〈0. 01 ],while the ET-1levels of the two groups with diabetes mellitus were significantly higher [（ 100. 25 ± 20. 34） and（ 77. 55 ± 14. 84） versus（ 53. 62 ± 8.40） ng/L,P〈0.01]than those of the group C. The NO levels of group A were significantly lower than in group B[（ 43.87 ±12.05） versus（ 53. 29 ± 11. 75） μmol/L,P〈0. 01]. Moreover,the ET-1 levels of the group A were significantly higher than in group B [（ 100. 25 ± 20. 34） versus（ 77. 55 ± 14. 84） ng / L,P〈0. 01]. Between the two diabetic groups,group A showed significantly higher systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,Hb A1 c,and course than group B（ P〈0. 01）. Correlation analysis showed a negative correlation between SBP,DBP,fasting blood glucose,Hb A1 c,and NO a positive correlation between high-density lipoprotein cholesterol（ HDL-C） and NO, a negative correlation between HDL-C and ET-1,and a positive correlation between SBP,LDL-C,uric acid,fasting blood glucose,Hb A1 c,and ET-1. Conclusion The serum levels of NO and ET-1 in diabetic patients are evidently abnormal. Vascular endothelium injury will become more serious in patients with complications. Therefore,the serum levels of NO and ET-1 in diabetic patients are correlated with control of blood glucose,blood pressure,and blood lipid levels.