多因素干预对新诊断2型糖尿病患者血管内皮功能的影响  

Effects of multifactorial intervention on the endothelial function in newly-diagnosed type 2 diabetic patients.

作　　者：姜玫[1] 白然[1] 杜建玲[1] 孙丽鹏[1] 孙国华[1] 巴颖[1] 杨郁[1] 邢倩[1] 李昌臣[1] 

机构地区：[1]大连医科大学第一附属医院

出　　处：《中国实用内科杂志：临床前沿版》2006年第6期918-920,共3页

基　　金："十五"国家科技攻关课题资助项目(2001BA702B01);辽宁省科技厅科技攻关项目(2002225003-6);辽宁省教育厅高等学校科学研究项目(202203266)

摘　　要：目的探讨多因素干预对新诊断2型糖尿病(T2DM)患者血管内皮功能的影响。方法于2003年3月至2004年3月对大连医科大学附属第一医院的112例病程在1年以内的T2DM患者,超声波测定颈动脉内中膜厚度(IMT)≤1·0mm,临床无心、脑、肾及外周血管等动脉粥样硬化性疾病的证据。随机分成4组:A组给予强化血糖、血压控制;B组给予强化血糖、血压、血脂控制;C组给予强化血糖、血压、血脂控制及联合维生素E治疗;D组给予强化血糖、血压、血脂控制及联合复方丹参滴丸治疗。超声检测各组干预前及1年后颈动脉IMT、反应性充血后内皮依赖性血管舒张(EDD)及舌下含服硝酸甘油后非内皮依赖性血管舒张(EIDD)功能。结果(1)各组颈动脉IMT干预前后差异均无统计学意义(P>0·05)。(2)干预后,B、C、D组EDD较干预前有所提高(P<0·05);A组干预前后及B、C、D组间比较差异均无显著性(P>0·05)。(3)干预后,C组EIDD较前改善(P<0·05),而A、B、D三组改善不显著(P>0·05)。结论同时降压、调脂后,EDD有所改善,而EIDD未见改善;联用维生素E改善了EIDD。Objective To explore the effects of multifactorial intervention on the endothelial function in newly - diagnosed type 2 diabetic patients. Methods In the First Affiliated Hospital of Dalian Medical University, 112 newly - diagnosed type 2 diabetic patients were investigated from March 2003 to March 2004. The carotid intima - media （IMT） measured by ultrasound was ≤ 1.0 mm. There was no clinical evidence for heart, brain, kidney and peripheral arterial disease. They were randomized in to 4 groups ： Group A （ intensive blood glucose and pressure control）, Group B （ intensive blood glucose, pressure and lipid control） , Group C （ intensive blood glucose, pressure, lipid control and a combination of vitamin E） and Group D （ intensive blood glucose, pressure, lipid control and a combination of compound Dansen dripping pills ）. IMT, endothelium - dependent vasodilation （EDD） and endothelium - independent vasodilation （EIDD） function were assessed in the brachial artery using B - mode high resolution ultrasound. Results （ 1 ） There were no significant changes of carotid IMT in four groups after intervention （ P 〉 0. 05 ）. （2） EDD was improved significantly in group B [ （9. 73 ± 1.37 ） % vs （ 8.53 ± 1.97 ） %, P 〈 0. 01 ], group C [ （9. 06 ± 1.68 ） % vs （8.10±2.04）%, P〈0.05] and groupD [ （9.64±1.93）% vs （9.04±1.94）%, P〈0.05], whileit was not improved significantly in group A [ （9. 98 ± 1.93） % vs （ 10. 04 ± 1.98） %, P 〉0. 05]. But there were no differences among group B, C and D （ P 〉 0. 05 ）. （3） The EIDD in group C was significan improved after intervention [ （ 15.79 ± 3. 63 ） % vs （ 18. 12 ± 4.70） % , P 〈 0. 05 ]. There was no significantly improvement in other three groups （ P 〉 0.05）, Conclusion The EDD is improved by blood glucose, pressure and lipid control. While the EIDD was not improved. There was no conspiracy effect on the EDD when blood glucose, pressure and lipid control is combined with

关 键 词：糖尿病 非胰岛素依赖型 内皮功能 多因素干预 

分 类 号：R5[医药卫生—内科学]