2型糖尿病患者主动脉根部顺应性对冠脉血流储备功能的影响

The Effect of Aortic Root Compliance on the Coronary Blood Flow Reserve (CFR) in Patients with type 2 diabetes

目的 探讨2型糖尿病主动脉根部顺应性对冠状动脉血流储备功能的影响。方法 选择2型糖尿病患者56例,其中 主动脉根部内径大于3.5cm者28例(A组),主动脉根部内径小于或等于3.5cm者28例(B组),冠状动脉造影正常的非2型糖尿病患者24例(C组)。用食道超声检测主动脉根部扩张度和僵硬度,同时检测冠状动脉血流储备。结果2型糖尿病组扩张度(D)为2.89±0.75(10~6cm^2/dgn),僵硬度(β)为5.35±2.83;对照组(C)组分别为3.48±0.94(10^(-6)cm^2/dgn),β值为6.54±2.61;B组分别为2.95±0.70(10^(-6)cm^2/dgn),5.13±2.45,两者比较均有显著性差异p<0.05。2型糖尿病患者D值与CFR呈显著正相关(r=0.373 p<0.05);β值与CFR呈显著负相关(r=-0.396p<0.0025);A组2型糖尿病患者主动脉根部内径与β值显著正相关(r=0.330 p<0.05)。结论 2型糖尿病患者存在不同程度的主动脉根部顺应性减退,导致冠状动脉血流储备功能的下降。

Objectives To study the effect of aortic root compliance on the CFR in patients with type 2 diabetes. Method we study 23 patients without diabetes (group C) ;55 patients with type 2 idabetes were divided to group (A > 3 .5cm in inner diameter of aortic root) and group B (≤3 .5cm in inner diameter of aortic root) . The following pqrameters were measured by transesophageal echocardiography(TEE) : dilatation (D), stiffness(β) and CFR. Results There was significant difference between type 2 diabetes and control group in D and β[patients with type 2 diabetes:D = 2.89±0.45(10-6cm2/dgn),β = 6.35±2.83;group C:D=3.85±0.24(10-6cm2/dgn),β=3.24±1.66,p<0.05].there was significant difference between group A and group B in D and β[group A:D = 2.10 ± 0.13(10- 6cm2/dgn) ,β= 8.74 ± 2.61;group B:D = 3.15±0.20(10-6cm2/dgn),β= 5.23±2.45,P<0.05],CFR was significantly related to D(r= 0.373,p < 0.005) and was negatively related to β(r = - 0.396, p < 0.0025) in patients with type 2 diabetes, the inner diameter of aortic root was negatively related to D (r = -0.331 p < 0.05) and was significantly related to β( r = 0.399 p < 0.025) Conclusion The compliance of aortic root was decreased significantly in the patients with type 2 diabetes, it also reduced the CFR.