2型糖尿病患者糖负荷前、后血管内皮依赖性舒张功能变化检测分析

Change of endothelium-dependent vasodilation before and after glucose load in type 2 diabetes

目的:通过对早期2型糖尿病患者糖负荷前、后血管内皮依赖性舒张功能变化检测,探讨餐后高血糖在糖尿病血管并发症中的危害。方法:采用高分辨率彩色多谱勒血管超声,以右侧肱动脉反应性充血前、后血管内径变化百分比反映血管内皮依赖性舒张功能,硝酸还原酶法测定血清一氧化氮(NO)水平,放射免疫法测定血清内皮素(ET)水平。结果:早期2型糖尿病患者糖负荷后较糖负荷前血管内皮依赖性舒张功能减退,d=-(14.4±9.7)%,t=9.39,P<0.01;血清NO、ET水平均较负荷前明显升高,NO,d=(25.23±20.17)μmol/L,t=7.91,P<0.01;ET,d=(16.5±12.4)ng/L,t=8.43,P<0.01。结论:早期2型糖尿病患者糖负荷后高血糖状态对血管内皮功能危害较糖负荷前大。

Objective:To determine the detriments of hyperglycemia after oral glucose load to dia-betic vascular diseases by assaying the change of endothelium-dependent vasodilation function in the early stage of type2diabetes before and after oral glucose load.Methods :With duplex ultrasound the brachial artery diameter was assessed,and the endothelium-dependent vasodilation was showed by the ratio of artery diameter change before and after tourniquet occlusion.Serum NO level was assessed by nitric acid reduc-tase;serum ET level was assessed by radio-immunity assay method.Results:In the early stage of type2diabetes,endothelium-dependent vasodilation function was impaired after oral glucose load compared with that after fast[d=-(14.4±9.7)%,t=9.39,P<0.01].The serum NO and ET level after oral glucose load were higher than those after fast[NO d=(25.23±20.17)μmol /L,t=7.91,P<0.01;ET,d=(16.5±12.4)ng /L,t=8.43,P<0.01].Con clu sion:In the early stage of type2diabetes,hyperglycemia after a glucose load may impair the endothelium-dependent vasodilation function.