高频超声评价糖化血红蛋白对糖尿病患者血管内皮功能的影响

Evaluation of glycohemoglobin on the endothelial function in diabetic patients with high-frequency ultrasound

目的 利用高频超声观测糖尿病患者血管内皮细胞功能及糖化血红蛋白对血管内皮功能的影响。方法 将 45例 2型糖尿病患者按糖化血红蛋白的水平分为两组 ,Ⅰ组 2 4例 ,糖化血红蛋白测值为静息状态下 6%～ 8%,Ⅱ组 2 1例 ,糖化血红蛋白测值为静息状态下 8%以上。应用高频超声检测糖尿病患者及 2 0例正常对照者的肱动脉在测值为静息状态下反应性充血后及舌下含服硝酸甘油后的内径变化。结果 糖尿病组肱动脉反应性充血前后的内径变化率明显低于对照组(P <0 .0 5 ) ,同时Ⅱ组明显低于Ⅰ组。含硝酸甘油后的肱动脉内径变化率 ,糖尿病组与对照组无明显差异 (P >0 .0 5 )。结论 糖尿病患者内皮依赖性血管舒张功能受损 ,糖化血红蛋白对内皮功能有一定的影响。应用高分辨力超声能够准确、无创地评价外周血管的内皮功能。

Objective To detect the endothelial function in diabetic patients using high-frequency ultrasound and evaluate the effect of glycohemoglobin (GHb) on the endothelial function.Methods The study group consisted of 45 patients with non-insulin-dependent diabetes mellitus(NIDDM) and 20 control subjects. The NIDDM patients were divided into two subgroups according to the level of GHB: DM groupⅠwhich level of GHB was 6%-8% and DM group Ⅱ which level of GHb was above 8%. The diameter of the brachial artery was measured at rest,after reaction hyperemia and after sublingual nitroglycerin using high-frequency ultrasound. Results The percent of diameter change of the brachial artery in response to reactive hyperemia was significantly lower in patients with NIDDM than that of control subjects,and this endothelial dysfunction was more significant in DM groupⅡ than in DM groupⅠ.The percent of diameter change of the brachial artery after sublingual nitroglycerin was not different between DM group and control group. Conclusion In patients with NIDDM,the endothelium-dependent vasodilatation is impaired and influenced by GHb to some degree. It is an accurate and noninvasive method to evaluate endothelial function of peripheral artery with high-frequency ultrasound.