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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。
Objective To evaluate the changes of early vascular function in hyperglycemic subjects by using extravascular ultrasound and arteriosclerosis analyzer and to explore the related factors. Methods 45 cases of impaired glucose tolerance, 40 cases of newly diagnosed T2DM, except for cardiovascular and cerebrovascular diseases and other diseases. Another 30 healthy people were selected as the control group. Respectively measured height, weight, blood pressure, fasting blood glucose, postprandial blood glucose, blood lipids, adiponectin, endothelin, high resolution ultrasound detection of bradyarrhythmia response to reactive hyperemia, the application of arterial sclerometer measured pulse wave Conduction velocity, comparing the three groups of different indicators of the crowd, and analyze the correlation. Results The acceleration of pulse wave velocity (1380 ± 266 cm / s, (1655 ± 336 cm / s)] and the blood flow-mediated endothelium-dependent vasorelaxation in patients with diabetes and impaired glucose tolerance (8.01% ± 5.82%, 4.97% ± 5.83%). The pulse wave velocity was positively correlated with endothelium-dependent vasodilation, systolic blood pressure, pulse pressure and fasting postprandial blood glucose and endothelin (r = 0.743,0.762,0.807,0.759,0.774, 0.790) and negatively correlated with adiponectin (r = -0.822). Conclusions There is vascular endothelial dysfunction in pre-diabetic and early diabetic patients. Endothelium-dependent vasodilation and pulse wave velocity are correlated with adiponectin and endothelin.