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目的:应用多普勒超声技术检测空腹血糖受损(IFG)与糖耐量受损(IGT)患者的血管内皮功能,探讨其对动脉粥样硬化的影响。方法:根据口服葡萄糖耐量试验(OGTT)结果,选择血糖正常(NGT)组25例,IFG组24例,IGT组22例,检测TC、TG、LDL-C、HDL-C、空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1C)、高敏C反应蛋白(hs-CRP)及血管性血友病因子(vWF),OGTT后2h血糖(2hPG)及2h胰岛素(2hINS),以及肱动脉内皮依赖性舒张功能(EDD)。结果:IGT组vWF较IFG组、NGT组明显升高[(170.25±21.76)%∶(155.16±17.19)%、(135.46±15.52)%,P<0.05～0.01],肱动脉EDD较IFG组、NGT组明显降低[(4.86±0.94)%∶(5.47±0.90)%、(6.24±0.97)%,P<0.05～0.01];IFG组vWF较NGT组明显升高[(155.16±17.19)%∶(135.46±15.52)%,P<0.05],肱动脉EDD较NGT组明显降低[(5.47±0.90)%∶(6.24±0.97)%,P<0.05]。多因素逐步回归分析显示,EDD与2hPG、LDL-C明显负相关(r分别为-0.73、-0.59,P<0.05)。结论:IGT较IFG对血管内皮功能危害更大,加强IGT防治对延缓动脉粥样硬化更为重要。
OBJECTIVE: To detect the vascular endothelium function in patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) by using Doppler ultrasonography and to explore its effect on atherosclerosis. Methods: According to oral glucose tolerance test (OGTT), 25 cases of normal glucose (NGT) group, 24 cases of IFG group and 22 cases of IGT group were selected for detection of TC, TG, LDL-C, HDL- , Fasting insulin (FINS), glycosylated hemoglobin (HbA1C), high sensitive C-reactive protein (hs-CRP) and vWF, 2hPG and 2hINS after OGTT, and brachial artery Endothelium-Dependent Diastolic Function (EDD). Results: The vWF in IGT group was significantly higher than that in IFG group and NGT group [(170.25 ± 21.76)% vs (155.16 ± 17.19)%, (135.46 ± 15.52)%, P <0.05-0.01] (4.86 ± 0.94)% vs (5.47 ± 0.90)%, (6.24 ± 0.97)% respectively, P <0.05 ~ 0.01]. The vWF in IFG group was significantly higher than that in NGT group [(155.16 ± 17.19)%] (135.46 ± 15.52)%, P <0.05]. The EDD of brachial artery was significantly lower than that of NGT group [(5.47 ± 0.90)% vs (6.24 ± 0.97)%, P <0.05]. Multi-step regression analysis showed that EDD was negatively correlated with 2hPG and LDL-C (r = -0.73, -0.59, P <0.05, respectively). CONCLUSION: IGT is more harmful to vascular endothelial function than IFG. It is more important to strengthen the prevention and treatment of IGT to delay atherosclerosis.