内皮依赖性血管舒张与2型糖尿病血管病变的关系

目的　探讨内皮依赖性血管舒张与 2型糖尿病 (2 DM )血管病变的关系及其可能原因。方法　利用彩色多普勒超声对 4 1例 2 DM患者和 12例正常人在反应性充血及含服硝酸甘油前后肱动脉内径进行检测 ,评价不同情况下 2 DM内皮依赖性血管舒张 (△D1% )及非内皮依赖性血管舒张 (△D2 % )反应的变化。结果　无论有无微血管病或动脉粥样硬化 ,所有病例△D1%均较正常人组显著减退 (P <0 0 0 1) ;而△D2 %在所有组间均无显著差异。结论　 2 DM在无大 /微血管病变时 ,内皮依赖性血管舒张功能显著减退 ,此变化可能参与了动脉粥样硬化、糖尿病微血管病变的发生 ;而非内皮依赖性血管舒张功能无变化。

The relationship between endothelium-dependent vasodilatation and angiopathy in type 2 diabetes mellitus

Objective To investigate the relationship between endothelium dependent vasodilatation(EDV) and angiopathy in type 2 diabetes mellitus. Methods To assess the flow mediated vasodilatation (endothelium dependent vascular relaxation) and nitroglycerin (a NO donor) induced vasodilatation (non endothelium dependent vascular relaxation) by measuring the diameter of the forearm brachial artery with color echo Doppler.Results The levels of △D 1% (the marker of endothelium dependent vascular relaxation) were reduced significantly in the patients with/without macro/microangiopathy compared with those of the controls ( P <0.01).The levels of △D 2% (the marker of non endothelium dependent vascular relaxation) did were not significantly vary in this study.Conclusion EDV is blunted in type 2 diabetes with and/or without macro/microangiopathy. Blunted EDV may play a role in the pathogenesis of diabetic macro/microangiopathy. However, non endothelium dependent vasodilatation dose not differ from the controls, so the reactivity of vascular smooth muscles to NO is not changed.