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目的 :探讨 2型糖尿病 (DM )患者血管内皮依赖性舒张功能的改变。方法 :用高分辨率超声检测 18例不伴微血管病变型DM患者、2 5例伴微血管病变型DM患者和 2 3例对照者的肱动脉流量介导的舒张 (FMD)和硝酸甘油介导的舒张 (NTG -MD)的功能。结果 :两组DM患者的FMD较对照组显著降低 [(8 0 3± 2 84) %和 (4 72± 2 79) %vs(10 .15± 3 86) % ,P分别为 <0 0 5及 0 0 1] ,其中伴微血管病变型DM组降低更明显 (P <0 0 1) ;不伴微血管病变型DM的NTG -MD与对照组比较无显著性差异 (P >0 0 5 ) ,但伴微血管病变型DM组的NTG -MD呈显著降低 [(10 72± 3 14 ) %vs(13 41± 3 97) %和 (13 0 3± 3 78) % ,P均 <0 0 5 ] ;FMD与空腹和餐后血糖水平及病程均呈负相关 (r =-0 .73、-0 .81、-0 .65 ,P均 <0 0 1)。结论 :2型DM患者存在显著的血管内皮功能障碍 ;肱动脉FDM的检测对DM患者的病情分析有重要的临床价值
Objective: To investigate the changes of endothelium-dependent vasodilation in patients with type 2 diabetes mellitus (DM). Methods: The brachial artery flow-mediated relaxation (FMD) in 18 patients with DM without DM, 25 DM with DM, and 23 controls were detected by high-resolution ultrasound and nitroglycerin-mediated Diastolic (NTG-MD) function. Results: The FMD in two DM patients was significantly lower than that in the control group [(803 ± 2 84)% vs (4272 ± 2 79)% vs (10.15 ± 3 86)%, P <0 05 (P <0.01). There was no significant difference in the NTG-MD between the DM group and the control group (P> 0.05), but there was no significant difference between the DM group and the control group However, the NTG-MD was significantly lower in the DM group with microangiopathy [(10 72 ± 3 14)% vs (13 41 ± 3 97)% and (13 0 3 ± 3 78)%, both P 0 05) ; FMD was negatively correlated with fasting and postprandial blood glucose levels and duration (r = -0.73, -0.81, -0.65, P <0.01). Conclusion: There is a significant vascular endothelial dysfunction in patients with type 2 DM. The detection of FDM in brachial artery has important clinical value in the analysis of DM patients