·糖尿病临床研究·

　　基金项目：河北省自然科学基金资助项目(C2009001352)

　　作者单位：050082石家庄，中国人民解放军白求恩国际和平医院内分泌科(胡丽叶、朱旅云、李晓玲);河北省人民医院(宋光耀)

　　通迅作者:宋光耀，E-mail：sguangyao@sohu.com

　　胡丽叶 宋光耀 朱旅云 李晓玲

　　【摘要】 目的 采用血管外超声技术及动脉硬化测定仪评价高血糖人群早期血管功能的改变，并探讨其相关影响因素。 方法 选取糖耐量异常者45例，新诊断的T2DM者40例，除外心脑血管疾病及其他疾病。另选取健康体检者30名作为对照组。分别测量身高、体重、血压，检测空腹血糖、餐后血糖、血脂、脂联素、内皮素，应用高分辨率超声检测肱动脉对反应性充血的舒张反应，应用动脉硬化测定仪测定其脉搏波传导速度，比较3组人群各项指标差异，并分析其相关性。 结果 糖尿病及糖耐量异常人群均出现脉搏波传导速度的加快[(1380±266)cm/s、(1655±336cm/s)]和血流介导的内皮依赖性血管舒张反应异常(8.01%±5.82%、4.97%±5.83%);脉搏波传导速度与内皮依赖性血管舒张反应、收缩压、脉压及空腹餐后血糖、内皮素呈正相关(r=0.743,0.762,0.807,0.759，0.774,0.790)，与脂联素呈负相关(r=-0.822)。 结论 糖尿病前期人群及糖尿病早期即有血管内皮功能障碍存在;内皮依赖性血管舒张功能和脉搏波传导速度与脂联素和内皮素相关。

　　【关键词】血糖;脉搏波传导速度;内皮依赖性血管舒张功能;动脉硬化;相关因素

　　doi:10.3969/j.issn.1006-6187.2011.11.012

　　Study on early change of endothelial function and related factors in hyperglycemia patients HU Li-ye, SONG Guang-yao, ZNH Lv-yun, et al. Department of Endocrinology, Baiqiu′en International Peace Hospital of PLA, Shijiazhuang 050082, China

　　Corresponding author: SONG Guang-yao, E-mail: sguangyao@sohu.com

　　【Abstract】 Objective To evaluate early change of endothelial function (EF) by color Doppler ultrasound and pulse wave velocity (PWV) in hyperglycemic people, and to probe the effects of related factors on EF and PWV. Methods 115 subjects (40 type 2 diabetes, 45 impaired glucose tolerance and 30 healthy people) aged 35 to 45 years, without cardio-cerebral-vascular disease and other disease, were chosen from March to December 2009. Height, weight, blood pressure were measured, and fasting blood glucose, postprandial blood glucose, adiponectin, endothelin and lipid profile were tested. Then all the subjects received pulse wave velocity and color Doppler ultrasound examination. Results The abnormality of pulse wave velocity and endothelium-dependent dilatation was found both in impaired glucose tolerance stage and early stage of type 2 diabetes[(1380±266)cm/s,(1655±336)cm/s for PWV and 8.01%±5.82%，4.97%±5.83% for EDD]as compared with NC group [PWV:(860±75) cm/s, EDD:10.7%±2.4%]. Systolic blood pressure, pulse pressure, endothelin, fasting blood glucose and postprandial blood glucose and endothelium-dependent dilatation were positively correlated with pulse wave velocity(r=0.743,0.762,0.807,0.759，0.774,0.790). And adiponectin was negatively correlated with PWV (r=-0.822). Conclusion Endothelial dysfunction exits in people with impaired glucose tolerance and type 2 diabetes. Pulse wave velocity and endothelium-dependent dilatation correlate with serum adiponectin and endothelin.

　　【Key words】 Blood glucose; Pulse wave velocity; Endothelium-dependent dilatation; Atherosclerosis; Related factor·糖尿病临床研究·