【摘要】 目的探讨糖尿病肢体动脉闭塞症患者血管内皮功能和颈动脉内膜中膜厚度的变化。方法60例糖尿病肢体动脉闭塞症患者为观察组,正常健康者20例为对照组。所有受检者均通过高频超声进行内皮依赖性舒张功能、非内皮依赖性舒张功能和颈动脉内膜中膜厚度检测,并测定内皮素1、血栓素B2、6-酮-前列腺素F1α和一氧化氮浓度。结果一、二及三期糖尿病肢体动脉闭塞症患者内皮依赖性舒张功能较健康对照者明显降低(8.39%±1.62%、6.22%±1.27%和4.02%±2.35%比10.58%±2.92%,P<0.01),三期糖尿病肢体动脉闭塞症患者非内皮依赖性舒张功能也明显下降(9.07%±6.36%比15.17±2.71%,P<0.01),二期和三期糖尿病肢体动脉闭塞症患者颈动脉内膜中膜厚度明显高于健康对照者(1.06±0.06mm和1.12±0.04mm比0.87±0.04mm,P<0.01)。糖尿病肢体动脉闭塞症患者内皮素1和血栓素B2水平明显高于健康对照者(P<0.01),一氧化氮、6-酮-前列腺素F1α水平明显低于健康对照者(P<0.01)。结论血管内皮功能障碍在糖尿病肢体动脉闭塞症的发病中起着重要作用,血管内皮功能和颈动脉内膜中膜厚度可作为监测和评估病情变化的指标。更多还原

【Abstract】 Aim To investigate the changes of vascular endothelial function and carotid artery intima-media thickness (IMT) in patients with diabetic arterial occlusion of lower extremities (DAO). Methods Using high resolution ultrasound, endothelium-dependent dilation (EDD), endothelium-independent dilation (EID) and IMT were measured in 60 patients with DAO (20 of 1st stage, 20 of 2nd stage and 20 of 3rd stage). 20 healthy people were respectively observed as the control group. Changes of vascular tension factors as endothelin-1 (ET-1), thromboxane B2 (TXB2), nitric oxide (NO) and 6-keto-prostaglandin F1α(6-Keto-PGF1α) were also be studied. Results The results show that EDD of the branchial artery in patients with DAO was reduced significantly compared with those healthy control and EDD has significantly characteristic changes in different stage (8.39%±1.62%, 6.22%±1.27%, and 4.02%±2.35% vs 10.58%±2.92%, P<0.01). EID of the branchial artery in patients of 3rd stage was also lower than those control (9.07%±6.36% vs 15.17%±2.71%, P<0.01). IMT of patients of 2nd and 3rd stage were significantly higher than those of healthy control group (1.06±0.06 mm and 1.12±0.04 mm vs 0.87±0.04 mm, P<0.01). Vascular contractile factors as ET-1 and TXB2 levels were higher than those in healthy control (P<0.01), while vascular dilatory factors as NO and 6-Keto-PGF1α were declined significantly than those in healthy control (P<0.01). Conclusions Vascular endothelial dysfunction may play an important role in the pathogenesis of DAO. Vascular endothelial function and IMT can be used to monitor patients condition.更多还原