2 型糖尿病患者颈动脉内膜中层厚度与血管内皮功能及粥样硬化程度的相关性。

Correlations of carotid intima-media thickness with endothelial function and atherosclerosis degree in patients with type 2 diabetes mellitus.

机构信息

Department of Ultrasound, Weihai Central Hospital, Weihai, Shandong, China.

出版信息

Clin Hemorheol Microcirc. 2019;72(4):431-439. doi: 10.3233/CH-180486.

DOI:10.3233/CH-180486

PMID:31006671

Abstract

OBJECTIVE

To investigate the correlation of carotid intima-media thickness (IMT) with endothelial function and atherosclerosis degree in patients with type 2 diabetes mellitus.

METHODS

A total of 80 patients with type 2 diabetes mellitus admitted and treated in our hospital from January 2017 to January 2018 were selected and randomly divided into two groups (n = 40). Patients who were definitely diagnosed with type 2 diabetes mellitus were selected as observation group, and individuals who received health examination and were excluded from type 2 diabetes mellitus were enrolled as control group. The diagnosed proportions of carotid plaque, Crouse scores, endothelial-dependent flow-mediated vasodilation (FMD) function and nitroglycerin-mediated dilation (NMD) function of the brachial arteries in the two groups were compared. The indexes related to vascular endothelial functions [vascular endothelial growth factor (VEGF), endothelin-1 (ET-1) and nitric oxide (NO) levels] in the two groups were detected. The correlations of Crouse score with brachial arterial FMD value, VEGF level, ET-1 level and NO level in observation group were analyzed.

RESULTS

The diagnosed proportion of carotid plaque in observation group was significantly higher than that in control group (P < 0.05), and the Crouse score in observation group was higher than that in control group (P < 0.05). The brachial arterial FMD value in observation group was remarkably lower than that in control group (P < 0.05). Compared with control group, VEGF and ET-1 levels were significantly reduced in observation group (P < 0.05), with the statistical increase of NO level (P < 0.05). In observation group, the Crouse score was negatively correlated with the brachial arterial FMD value, VEGF level and ET-1 level, whereas positively correlated with the NO level (P < 0.05).

CONCLUSION

Our data show that the carotid IMT is increased significantly among patients with type 2 diabetes mellitus, and the vascular endothelial function is impaired. Moreover, after the occurrence of atherosclerosis, we found the carotid IMT is negatively correlated with endothelial-dependent FMD, as well as levels of VEGF and ET-1, whereas shows positive correlation with the vasodilative factor NO.

摘要

目的

探讨 2 型糖尿病患者颈动脉内膜中层厚度（IMT）与内皮功能及动脉粥样硬化程度的相关性。

方法

选取 2017 年 1 月至 2018 年 1 月我院收治的 80 例 2 型糖尿病患者，随机分为两组（n=40）。确诊为 2 型糖尿病的患者作为观察组，健康体检并排除 2 型糖尿病的个体作为对照组。比较两组颈动脉斑块检出率、Crouse 评分、肱动脉内皮依赖性血流介导的血管舒张功能（FMD）及硝酸甘油介导的血管舒张功能（NMD）。检测两组血管内皮功能相关指标[血管内皮生长因子（VEGF）、内皮素-1（ET-1）、一氧化氮（NO）水平]。分析观察组 Crouse 评分与肱动脉 FMD 值、VEGF 水平、ET-1 水平、NO 水平的相关性。

结果

观察组颈动脉斑块检出率明显高于对照组（P<0.05），Crouse 评分高于对照组（P<0.05）。观察组肱动脉 FMD 值明显低于对照组（P<0.05）。观察组 VEGF 和 ET-1 水平明显降低，NO 水平明显升高（P<0.05）。观察组 Crouse 评分与肱动脉 FMD 值、VEGF 水平、ET-1 水平呈负相关，与 NO 水平呈正相关（P<0.05）。