糖尿病和高血压对人体大动脉物理特性的比较影响。

Comparative effects of diabetes mellitus and hypertension on physical properties of human large arteries.

作者信息

Megnien J L, Simon A, Valensi P, Flaud P, Merli I, Levenson J

机构信息

Centre de Médecine Préventive Cardio-vasculaire, INSERM U 28, Hôpital Broussais, Paris, France.

出版信息

J Am Coll Cardiol. 1992 Dec;20(7):1562-8. doi: 10.1016/0735-1097(92)90451-r.

DOI:10.1016/0735-1097(92)90451-r

PMID:1452931

Abstract

OBJECTIVES

The effects of hypertension and diabetes on the physical properties of large arteries were compared in men.

BACKGROUND

Although these two diseases are linked to vascular stiffening, no study has analyzed whether the arterial rigidity in diabetes is as substantial as in hypertension.

METHODS

Noninvasive measurements of brachial artery mean pressure, diameter (pulsed Doppler study) and compliance (pulse wave velocity) were obtained in 29 men: 11 control subjects, 9 hypertensive nondiabetic patients and 9 diabetic normotensive patients. Individual diameter- and compliance-pressure curves extrapolated from the measured diameter and mean pressure point with a logarithmic elastic model permitted calculation of isobaric diameter and compliance at the same pressure in each subject.

RESULTS

Compared with control subjects, hypertensive patients had a larger brachial artery measured diameter and isobaric diameter (p < 0.01) and lower measured and isobaric compliance (p < 0.001, p < 0.01). Compared with control subjects, diabetic patients had lower measured and isobaric compliance (p < 0.01). Comparison of diabetic and hypertensive patients showed that measured diameter and isobaric diameter were decreased in the former (p < 0.01). In the control and hypertensive groups, mean pressure correlated positively with measured diameter and isobaric diameter (p < 0.01) and negatively with measured and isobaric compliance (p < 0.001 and p < 0.01, respectively). In the control and diabetic groups, fasting glucose correlated negatively with measured and isobaric compliance (p < 0.01, p < 0.05).

CONCLUSIONS

Intrinsic alterations of the large artery independent of a stretching pressure effect reduce arterial elasticity similarly in those with hypertension or diabetes. The loss of compliance is related to the chronic elevation of blood pressure in hypertension and to that of glycemia in diabetes and is associated with a relative large artery vasoconstriction in diabetic patients as compared with patients with hypertension.

摘要

目的

比较高血压和糖尿病对男性大动脉物理特性的影响。

背景

尽管这两种疾病都与血管硬化有关，但尚无研究分析糖尿病患者的动脉僵硬度是否与高血压患者一样严重。

方法

对29名男性进行无创测量肱动脉平均压、直径（脉冲多普勒研究）和顺应性（脉搏波速度）：11名对照受试者、9名高血压非糖尿病患者和9名糖尿病血压正常患者。使用对数弹性模型从测量的直径和平均压点外推个体直径和顺应性压力曲线，从而计算出每个受试者在相同压力下的等压直径和顺应性。

结果

与对照受试者相比，高血压患者的肱动脉测量直径和等压直径更大（p<0.01），测量顺应性和等压顺应性更低（p<0.001，p<0.01）。与对照受试者相比，糖尿病患者的测量顺应性和等压顺应性更低（p<0.01）。糖尿病患者与高血压患者的比较显示，前者的测量直径和等压直径减小（p<0.01）。在对照组和高血压组中，平均压与测量直径和等压直径呈正相关（p<0.01），与测量顺应性和等压顺应性呈负相关（分别为p<0.001和p<0.01）。在对照组和糖尿病组中，空腹血糖与测量顺应性和等压顺应性呈负相关（p<0.01，p<0.05）。