Katedra i Klinika Neurologii, Śląski Uniwersytet Medyczny, Katowice, Polska.
Neurol Neurochir Pol. 2012 Nov-Dec;46(6):529-35. doi: 10.5114/ninp.2012.32175.
Diabetes mellitus (DM) is an in-dependent risk factor for cardiovascular diseases. The origin of diabetic microangiopathy is multifactorial; it affects all layers of the artery wall, causing endothelial and vasoreactivity impairment. The incidence of cerebral vasoreactivity failure in diabetic patients without stroke history is not precisely determined yet. The aim of the study was to assess the cerebrovascular reactivity in hypocapnia and hypercapnia in patients with type 2 DM with or without arterial hypertension without artery stenosis and stroke history, with the use of transcranial Doppler examination.
The mean blood flow velocity, pulsatility index and parameters of cerebrovascular reactivity were measured in 53 patients with type 2 DM (aged 42-72 years, mean 59.5 ± 7.9) and in 27 healthy volunteers (aged 36- 74 years, mean 57.0 ± 10.4). Diabetics were further divided into two subgroups according to the presence or absence of arterial hypertension.
The index of cerebrovascular reactivity in hypocapnia and hypercapnia was significantly worse and time needed to normalization of blood flow velocity was significantly longer in patients with DM in comparison with healthy volunteers.
Most DM type 2 patients without stroke history had decreased values of cerebral vasoreactivity parameters, which suggests the presence of microangiopathy.
糖尿病（DM）是心血管疾病的独立危险因素。糖尿病微血管病变的起源是多因素的；它影响动脉壁的所有层，导致内皮和血管反应性受损。患有 2 型糖尿病且无卒中病史的患者脑血管反应失败的发生率尚未精确确定。本研究的目的是使用经颅多普勒检查评估无动脉狭窄和卒中病史的伴有或不伴有动脉高血压的 2 型 DM 患者在低碳酸血症和高碳酸血症时的脑血管反应性。
在 53 名 2 型 DM 患者（年龄 42-72 岁，平均 59.5 ± 7.9 岁）和 27 名健康志愿者（年龄 36-74 岁，平均 57.0 ± 10.4 岁）中测量平均血流速度、搏动指数和脑血管反应性参数。根据是否存在动脉高血压，将糖尿病患者进一步分为两组。
与健康志愿者相比，低碳酸血症和高碳酸血症时的脑血管反应指数明显更差，血流速度恢复正常所需的时间明显更长。
大多数无卒中病史的 2 型 DM 患者的脑血管反应性参数值降低，这表明存在微血管病变。
