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目的为了探讨糖耐量减低(IGT)患者联合干预治疗前后内皮功能的变化。方法选择28例IGT患者,和年龄、性别匹配的健康个体25人。IGT患者采用控制饮食、规则的有氧运动及口服二甲双胍联合干预治疗12周。采用高分辨血管外超声法检测肱动脉内皮依赖性血管舒张功能和内皮非依赖性血管舒张功能。结果IGT患者干预治疗前内皮依赖性血管舒张功能为3.50%,明显低于对照组的4.68%(P<0.05)。多元逐步回归分析结果显示,内皮依赖性血管舒张功能与年龄、LDL-C、Lp(a)、HbA1c、FPG及2hPG呈负相关(P<0.001)。经联合干预治疗12周后,内皮依赖性血管舒张功能明显增高,达到4.17%,明显高于IGT患者干预治疗前(P<0.05)。Spearman分析结果显示,治疗前后内皮依赖性血管舒张功能的变化与FBG、2hBG、LDL-C、HbA1c的变化呈负相关(P<0.05)。结论IGT患者内皮依赖性血管舒张功能降低。联合干预治疗可改善血管内皮功能。
Objective To investigate the changes of endothelial function in patients with impaired glucose tolerance (IGT) before and after combined intervention. Methods Twenty-eight IGT patients were selected, and 25 healthy individuals were matched with age and sex. IGT patients were controlled diet, regular aerobic exercise and oral metformin combined intervention for 12 weeks. The brachial artery endothelium-dependent vasodilation and endothelium-independent vasodilatation were measured by high resolution extracorporeal ultrasonography. Results The endothelium-dependent vasodilation before IGT was 3.50%, which was significantly lower than that of the control group (4.68%, P <0.05). Multiple stepwise regression analysis showed that endothelium-dependent vasodilation was negatively correlated with age, LDL-C, Lp (a), HbA1c, FPG and 2hPG (P <0.001). After 12 weeks of combined intervention, endothelium-dependent vasodilation was significantly increased to 4.17%, significantly higher than that before IGT intervention (P <0.05). Spearman analysis showed that the changes of endothelium-dependent vasodilation before and after treatment were negatively correlated with the changes of FBG, 2hBG, LDL-C and HbA1c (P <0.05). Conclusion IGT patients with endothelium-dependent vasodilation decreased. Joint intervention can improve vascular endothelial function.