Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital Affiliated to Nanjing Medical University, Nanjing, People's Republic of China.
Diab Vasc Dis Res. 2013 May;10(3):208-15. doi: 10.1177/1479164112456310. Epub 2012 Sep 12.
We studied the impact of diabetes mellitus (DM) on the radial artery (RA) in 30 patients with DM and 30 non-diabetic patients undergoing coronary artery bypass grafting with autologous RA. RAs were recorded as normal if there was no cellular or stromal tissue between the endothelium and the internal elastic lamina. The RA was normal in 26.7% of diabetic and 76.7% of non-diabetic patients (p = 0.000298). Intimal thickness index and intima:media ratio were higher in the former than in the latter (p < 0.05; p < 0.05), with no significant difference in luminal narrowing (p > 0.05). Electron microscopy scores were lower in the non-diabetic group (p < 0.001); endothelial nitric oxide synthase (eNOS) protein expression and optical density were higher (p < 0.001). Von Willebrand factor and endothelin-1 messenger RNA (mRNA) levels were higher in the DM patients (p < 0.001). The quality of the RA in patients with DM was thus inferior to that in non-diabetic patients. Care should be taken when selecting RA as a conduit in patients with DM.
我们研究了 30 例糖尿病(DM)患者和 30 例非糖尿病患者的桡动脉(RA)在冠状动脉旁路移植术中自体 RA 的影响。如果内皮细胞和内弹性膜之间没有细胞或基质组织,则 RA 被记录为正常。糖尿病患者中正常 RA 占 26.7%,而非糖尿病患者中占 76.7%(p = 0.000298)。前者的内膜厚度指数和内膜:中膜比值高于后者(p < 0.05;p < 0.05),但管腔狭窄无显著差异(p > 0.05)。非糖尿病组的电子显微镜评分较低(p < 0.001);内皮型一氧化氮合酶(eNOS)蛋白表达和光密度较高(p < 0.001)。糖尿病患者的血管性血友病因子和内皮素-1 信使 RNA(mRNA)水平较高(p < 0.001)。因此,糖尿病患者的 RA 质量不如非糖尿病患者。在选择 RA 作为糖尿病患者的移植物时应谨慎。