波动性高血糖对血管内皮功能的影响  

Effect of fluctuating high blood glucose level on vascular endothelial function

作　　者：李雷[1] 杨荣礼[1] 吕丽丽[1] 李平静[1] 王春晴[1] 杨煜[1] 

机构地区：[1]徐州医学院附属医院老年病科,221006

出　　处：《中华老年心脑血管病杂志》2012年第8期831-833,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的观察波动性高血糖对血管内皮功能的影响,探讨其致动脉粥样硬化的机制。方法选择新诊断的2型糖尿病患者72例,根据动态血糖监测结果分持续性高血糖组33例和波动性高血糖组39例,检测患者的肱动脉内皮依赖性舒张功能(EDD)及颈动脉内膜中层厚度(IMT)、血脂、空腹血糖、空腹胰岛素、餐后2 h血糖(2hPG)及餐后2 h胰岛素(2hINS)、高敏C反应蛋白(hs-CRP)、血管性假血友病因子(vWF)及尿微量白蛋白(MAU)。结果与持续性高血糖组比较,波动性高血糖组的2hPG、2hINS、hs-CRP、vWF、MAU及IMT明显升高(P<0.05,P<0.01),肱动脉EDD明显降低[(6.61±0.79)%vs(5.21±0.88)%,P<0.01]。结论波动性高血糖较持续性高血糖对血管内皮功能危害更大,可能与餐后高血糖、胰岛素抵抗和炎性因子增多有关。Objective To observe the effect of fluctuating high blood glucose level on vascular endothelial function and its mechanism underlying atherosclerosis. Methods Seventy-two newly diagnosed type 2 diabetic mellitus patients were divided into persistent high blood glucose level group（n=33） and fluctuating high blood glucose level group（n=39） acording to their dynamic blood glucose monitoring. Their brachial endothelium-dependent dilation（EDD）,carotid IMT,and levels of lipid, fasting plasma glucose, fasting insulin, postprandial 2 h plasma glucose（2hPG）, postprandial 2 h insulin（2hlNS）, hs-CRP, vWF, and microalbuminuria（MAU） were measured. Re- sults The postprandial 2hPG and 2hINS,hs-CRP,vWF,MAU and IMT levels were significantly higher（P〈0.05,P〈0.01） while the brachial EDD was significantly lower（6.61%±0.79% vs 5.21%±0.88%,P〈0.01） in fluctuating high blood glucose level group than in persistent high blood glucose level group. Conclusion Fluctuating high blood glucose level is more harmful than persistent high blood glucose level to vascular endothelial function,which may be related with the postprandial hyperglycemia,insulin resistance and increasing inflammatory factors.

关 键 词：高血糖症 内皮 血管 糖尿病 2型 C反应蛋白质 

分 类 号：R587.1[医药卫生—内分泌]