老年糖尿病患者冠状动脉血流储备的变化

Coronary flow reserve in elderly diabetes patients

目的 应用彩色多普勒超声仪检测冠状动脉血流储备 (CFR) ,观察老年糖尿病患者 CFR的变化。方法 2 5例老年糖尿病患者为患者组 ,2 5例健康志愿者为对照组 ,比较两组的空腹血糖 (FBG)、餐后 2 h血糖 (P2 h BG)、糖化血红蛋白 (Hb A1 C)、总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL- C)及甘油三酯 (TG)、内皮素 - 1 (ET- 1 )、静息状态时患者冠状动脉的基础血流速度 (b FV)、潘生丁注射后的最大血流速度 (m FV)及 CFR。结果 糖尿病组的 FBG、P2 h BG、Hb A1 C、TG及 ET- 1水平显著高于对照组〔分别为 :9.1 2± 3.2 6 mmol/ L与 5.34± 0 .76 mmol/ L ;1 5.78± 4.98mmol/L 与 6.89± 2 .38mmol/ L;(6.3h8.5) %与 (5.2± 7.9) % ;2 .96± 0 .56与 1 .69± 0 .82 mmol/ L及 1 53.91± 1 3.50 pg/ ml与 76.2 3± 1 0 .78pg/ ml,P均<0 .0 1〕,两组的 TC及 LDL- C水平无显著差异 ,静息时的基础冠脉血流速度 (b FV)较对照组轻度上升 (P>0 .0 5) ,而潘生丁注射后 m FV及 CFR(CFR=m FV/ b FV)较对照组明显下降 (分别为 58.1± 7.9cm/ s与 73.5± 9.8cm/ s及 2 .31± 0 .49与 3.58± 0 .46,P均 <0 .0 1 )。结论 老年糖尿病患者冠状动脉血流储备明显下降。

Objective To evaluate the coronary flow reserve in elderly patients with diabetes mellitus by Color Doppler ultrasound.Methods 25 healthy subjects as control group and 25 elderly diabetes patients as patients group were studied. The concentrations of fest blood glucose (FBG),2-hour-post-breakfast blood glucose (P2hBG),Total cholesterol(TC), low density lipid cholesterol(LDL-C), triglyceride(TG),endothelin-1(ET-1),basal coronary flow velocity (bFV), maximal flow velocities(mFV) after infusion of dipyridamole and coronary flow reserve(CFR)in diabetes patients group were compared with those in the control group.Results The concentrations of FBG, P2hBG, TG and ET-1 in diabetes group were much higher than those in control group〔 (9.12±3.26) mmol/L vs (5.34±0.76) mmol/L; (15.78±4.98) mmol/L vs (6.89±2.38) mmol/L; (2.96±0.56) mmol/L vs (1.69±0.82) mmol/L and(153.91±13.50) pg/ml vs (76.23±10.78) pg/ml, P<0.01, respectively〕. The bFV and the concentrations of TC and LDL-C in diabetes group have no significant difference from those in control group. After infusion of dipyridamole, the mFV of coronary and the CFR in diabetes(CFR=mFV /bFV ) group were obviously lower than those in controls 〔(58.1±7.9)cm/s vs (73.5±9.8)cm/s and 2.31±0.49 vs 3.58±0.46, P<0.01, respectively〕.Conclusions The coronary flow reserve and endothelium function in elderly diabetes mellitus patients were greatly damaged.