老年2型糖尿病患者内皮依赖性舒张功能及颈、股动脉粥样硬化的研究

Study on the atherosclerosis of carotid and femoral arteries and the endothelial function in elderly diabetics

目的 探讨老年 2型糖尿病患者内皮依赖性舒张功能及颈、股动脉粥样硬化的状况。 方法 利用彩色多普勒超声检测 3 0例无糖尿病健康老年人 (对照组 )、3 2例单纯 2型糖尿病 (糖尿病 1组 )及 3 5例 2型糖尿病并冠心病患者 (糖尿病 2组 )肱动脉内皮依赖性舒张功能 ,颈动脉内膜中层厚度 (IMT)及颈动脉、股动脉、腹主动脉斑块的发生状况。 结果 糖尿病 2组反应性充血所致肱动脉内径的舒张为 (2 81± 1 5 6) % ,较糖尿病 1组 (5 5 8± 1 13 ) %下降 ,两组均较对照组 (9 63±1 81) %下降 (P <0 0 5 )。糖尿病 2组颈总动脉IMT为 (1 0 5± 0 16)mm ,较糖尿病 1组 (0 92±0 13 )mm增高 ,两组均较对照组 (0 78± 0 0 7)mm增高 (P <0 0 5 )。糖尿病各组颈动脉、股动脉、腹主动脉的斑块指数均较对照组增高 (P <0 0 5 )。 结论 糖尿病患者内皮依赖性舒张功能下降 。

Objective To investigate atherosclerosis of carotid and femoral arteries and the endothelial function in elderly diabetics. Methods The endothelium dependent relaxing function of blood vessels, intima media thickness (IMT) of carotid arteries, and the plaque in carotid and femoral arteries were measured using B mode ultrasound in 32 elderly diabetics, 35 elderly patients with both diabetics and coronary artery disease(CAD), and 30 controls. Results The flow mediated dilatation in the group with both diabetics and CAD(2 81±1 56)% was significantly lower than that in the single diabetic group(5 58±1 13)%, and both groups were significantly lower than that of the control group 〔(9 63± 1 81 )%, P <0 05〕. The IMT of common carotid arteries in the group with both diabetics and CAD (1 05±0 16 )mm was significantly higher than that of the diabetic group (0 92±0 13)mm, and IMT in both groups was significantly higher than that of the control group 〔(0 78±0 07) mm, P <0 05〕. The plaque index of carotid and femoral arteries in the two diabetic groups was significantly higher than that of the control group( P <0 05). Conclusions The endothelium dependent vasodilatation was impaired in elderly diabetics. The aged diabetics is of higher incidence of atherosclerosis of main arteries since the endothelium dependent relaxing function decreased.