Enderle M D, Balletshofer B M, Schmülling R M, Häring H U, Pfohl M
Medizinische Klinik, Universität Tübingen.
Ultraschall Med. 1998 Feb;19(1):16-21. doi: 10.1055/s-2007-1000453.
Endothelial Dysfunction (ED) is an early functional marker and Intima-Media-Thickness (IMT) an early morphological parameter of atherogenesis. Is there a simple, non-invasive routine method for the identification of atherosclerosis including the detection of the early functional endothelial impairment seen for example in Type 2 diabetic patients?
Using high resolution ultrasound we studied peripheral endothelial function expressed as flow-associated dilation (FAD %) and endothelial independent vasodilation after administration of 400 micrograms glycerol trinitrate (postnitro %) of the brachial artery as well as IMT of the common carotid artery in 25 Type 2 diabetic patients and their matched controls.
(mean +/- SD): The diabetic patients showed a remarkable ED (FAD%: 3.8 +/- 3.3 vs. 6.9 +/- 4.4%, p = 0.01) and an already increased IMT (0.72 +/- 0.14 vs. 0.62 +/- 0.10 mm, p < 0.01). The similar postnitro % in diabetic patients and controls suggests normal dilating capacity of the studied vessels in the diabetic patients (postnitro %: 14.3 +/- 9.4 vs. 14.9 +/- 8.5%, p = ns).
With a combination of these three sonomorphological parameters it is possible to document the stage of atherosclerosis including endothelial dysfunction in Type 2 diabetic patients.
内皮功能障碍（ED）是动脉粥样硬化形成的早期功能标志物，而内膜中层厚度（IMT）是早期形态学参数。是否存在一种简单、非侵入性的常规方法来识别动脉粥样硬化，包括检测例如2型糖尿病患者中所见的早期功能性内皮损伤？
我们使用高分辨率超声研究了25名2型糖尿病患者及其匹配对照组的外周内皮功能，以外周动脉血流介导的舒张（FAD%）表示，以及给予400微克硝酸甘油后肱动脉的内皮非依赖性血管舒张（硝酸甘油后%），同时还研究了颈总动脉的IMT。
（均值±标准差）：糖尿病患者表现出明显的内皮功能障碍（FAD%：3.8±3.3对6.9±4.4%，p = 0.01），并且IMT已经增加（0.72±0.14对0.62±0.10毫米，p < 0.01）。糖尿病患者和对照组的硝酸甘油后%相似，表明糖尿病患者所研究血管的舒张能力正常（硝酸甘油后%：14.3±9.4对14.9±8.5%，p = 无显著性差异）。
结合这三个超声形态学参数，可以记录2型糖尿病患者动脉粥样硬化的阶段，包括内皮功能障碍。
