2型糖尿病对冠心病患者大隐静脉旁路血管内皮细胞的影响  

The impact of type 2 diabetes on endothelium of great saphenous vein in patients with coronary heart disease

作　　者：李世康[1] 栗振坤[1] 龙村[2] 何立术[1] 周琦云[1] 胡应学[1] 

机构地区：[1]广西医科大学第一附属医院心胸外科,南宁530021 [2]中国医学科学院阜外心血管病医院麻醉和体外循环研究室

出　　处：《中华胸心血管外科杂志》2011年第8期480-482,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：本课题受广西医疗卫生重点科研课题（重200827）和广西教育厅科研基金（200710MS152）资助

摘　　要：目的探讨2型糖尿病对冠心病患者大隐静脉血管内皮细胞的影响。方法选取预行冠状动脉旁路移植术40例患者，其中冠心病合并2型糖尿病20例（试验组）及无糖尿病20例（对照组）。每例均取其大隐静脉旁路血管的远心端1cm长的血管环，切成3段。分别观察血管内皮形态学的变化及采用器官管槽法，在37％有氧条件下，检测苯肾上腺素（10^-5mol／L）引起的血管收缩反应、以及不同浓度（10^-910^-5mol／L）的硝酸甘油、乙酰胆碱引起的血管舒张反应。结果试验组大隐静脉超微结构受损程度较对照组严重。苯肾上腺素引发的预收缩强度和硝酸甘油引发的非内皮依赖性舒张反应两组差异无统计学意义（P〉0．05），但乙酰胆碱引发的内皮依赖性最大舒张反应，试验组明显低于对照组（P〈0．05）。结论2型糖尿病会加重冠心病患者大隐静脉旁路血管内皮细胞的损害。Objective To study the impact of type 2 diabetes mellitus on endothelium of great saphenous vein in patients with coronary heart disease. Methods Patients undergoing coronary artery bypass grafting were selected, 20 with type 2 diabetes mellitus （ experimental group） and another 20 patients without （ control group）. The rings of great saphenous vein in 1 cm length were taken from those patients and then divided into 3 segments. The structure of endothelium was evaluated by the microscope and the changes of venous tone were measured in organ chamber at 37℃ with a constant supply of oxygen. Venous vasoconstriction was induced by phenylephrine （10-5 mol/L） and vasodilatation induced by nitroglycerin or acetylcholine （10 -9 - 10 -5mol/L）. Results More damages of ultrastructure of the endothelium of saphenous vein were found in experimental group than in control group. There were no significant differences regarding the venous tone between the two groups （P 〉 0.05 ） when vasoconstriction induced by phenylephrine and vasodilatation by nitroglycerin. However, the vasodilatation induced by acetylcholine was significantly decreased in experimental group than in control group （ P 〈 0.05 ）. Conclusion Type 2 diabetes mellitus can aggravate the damage of endothelium of saphenous vein in patients with coronary artery disease.

关 键 词：糖尿病 非胰岛素依赖型 冠状动脉疾病 大隐静脉 内皮 冠状动脉分流术 

分 类 号：R587[医药卫生—内分泌] R541[医药卫生—内科学]