老年糖尿病患者脉搏波速度与动脉顺应性的临床研究  

Clinical characteristic of pulse wave velocity and arterial compliance in elderly patients with diabetesmellitus

作　　者：张红[1] 张惠云[3] 邱洁 王琰 刘春梅[1] 初英虹[1] 周荣香[1] 张瑶[1] 高海青 

机构地区：[1]山东大学齐鲁医院老年病科,250012 [2]山东省心血管疾病蛋白质组学重点实验室,250012 [3]山东省千佛山医院医学工程部,250012

出　　处：《中华老年医学杂志》2013年第6期605-608,共4页Chinese Journal of Geriatrics

基　　金：山东省科技发展计划项目（2012GB021817）;山东省科技攻关计划项目（2010GGC10294）;国家科技重大专项子课题（2012ZX09303016-003）

摘　　要：目的研究老年糖尿病患者脉搏波速度和动脉顺应性与心血管危险因素的临床特点。方法363例患者分别为糖尿病组、糖尿病合并高血压组、高血压组与健康对照组，应用Coraplior动脉脉搏波速度测定仪测量颈股脉搏波速度（CF—PWV）；测量大动脉弹性指数（C1）和小动脉弹性指数（C2）。结果糖尿病组、糖尿病合并高血压组的CF-PWV较对照组均升高（t值分别为3．24、5．38，P％0．05或0．01）；糖尿病组、糖尿病合并高血压组C2与对照组比较均降低（t值分别为6．88、3．96，P％0．05或0．01）。CF-PWV与年龄、腰臀比、空腹血糖、收缩压、舒张压、脉压、平均动脉压呈正相关（r值分别为0．34、0．13、0．18、0．46、0．13、0．48、0．29，均P％0．05）；C2与年龄、空腹血糖、收缩压、舒张压、脉压和平均动脉压呈负相关（r值分别为0．29、-0．15、-0．35、-0．17、-0．31、0．28，P％0．05）；C2与体质指数呈正相关（r=0．16，P〈0．05）；CF-PWV与C2呈负相关（r=-0．19，P〈0．05）。结论老年糖尿病患者存在动脉弹性的下降，年龄、血糖及血压水平是引起上述指标改变的危险因素；CF-PWV和C2可作为评价糖尿病动脉弹性功能异常的无创性敏感性指标。Objective To explore the clinical characteristics of pulse wave velocity, arterial compliance and cardiovascular risk factors in elderly patients with type 2 diabetes mellitus. Methods A total of 363 patients were selected and divided into 4 groups： diabetic group, diabetic- hypertensive group, hypertensive group and healthy control group Carotid-femoral pulse wave velocity （CF-PWV） was measured by a validated Complior automatic device Capacitive arterial compliance （C1） and oscillatory arterial compliance （C2） were measured using CVProfilor DO-2020. Results The levels of CF-PWV were higher in diabetic group and diabetic-hypertensive group than in healthy control group （t =3.24, 5.38, P〈0.05, 0.01）. The levels of C2 were lower in diabetic group and diabetic-hypertensive group than in healthy control group （t：6.88, 3.96, P〈0.05, 0.01） ~ CF-PWV had positive correlations with age, waist to hip ratio, fasting blood glucose （FBG）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, pulse pressure and mean artery pressure （MAP） （r=0.34, 0.13, 0.18, 0.46, 0.13, 0.48, 0.29, all P〈0.05） C2 had negative correlations with age, FBG, SBP, DBP, Pulse pressure and MAP（r=- 0.29, 0.15, - 0.35, -0.17, -0.31, --0.28, all P〈0.05）, and had a positive correlation with BMI（r=0.16, P〈0.05） CF-PWV had a negative correlation with C2 （r =-0.19, P 〈 0.05）. Conelusions Arterial compliance is impaired in elderly patients with diabetes mellitus, age, blood glucose and blood pressure are the risk factors. CF-PWV and C2 measurements are noninvasive and sensitive indicators for evaluating abnormalities in arterial compliance in patients with diabetes mellitus.

关 键 词：糖尿病 脉搏 动脉 

分 类 号：R544.1[医药卫生—心血管疾病]