山东医药
山東醫藥
산동의약
SHANDONG MEDICAL JOURNAL
2014年
39期
19-22,26
,共5页
吕以培%黄文萍%车红英%张素华%黄中莹%陈建西%杨丕坚%李舒敏%卢伟波%黄虹
呂以培%黃文萍%車紅英%張素華%黃中瑩%陳建西%楊丕堅%李舒敏%盧偉波%黃虹
려이배%황문평%차홍영%장소화%황중형%진건서%양비견%리서민%로위파%황홍
空腹血糖受损%糖耐量受损%肥胖%内皮功能%代谢功能
空腹血糖受損%糖耐量受損%肥胖%內皮功能%代謝功能
공복혈당수손%당내량수손%비반%내피공능%대사공능
impaired fasting glucose%impaired glucose tolerance%obesity%endothelial function%metabolic function
目的:观察空腹血糖受损并糖耐量受损( IFG+IGT)患者血管内皮功能及代谢功能情况。方法选择IFG+IGT者72例( E组),其中非肥胖30例( E1组),肥胖42例( E2组);另选择糖耐量正常的健康人群142例( N组),其中非肥胖75例( N1组)、肥胖67例( N2组)。做口服葡萄糖耐量试验及胰岛素释放试验检测血糖、免疫活性胰岛素,同时检测空腹血脂、游离脂肪酸、脂联素。采用免疫比浊法检测超敏C反应蛋白( hs-CRP),RIA法检测血清内皮素( SET)。留取晨尿,采用未抽提法测定内皮素( UET),散射比浊法检测尿微量白蛋白( MUA)。观察血压和腰围。彩超测定肱动脉休息时、加压及服用硝酸甘油后的内径变化,计算内皮依赖性血管舒张功能( EDD)及内皮非依赖性血管舒张功能( EID)指标(ΔD%、ΔD1%)。结果校正性别、年龄后,E和N组比较、E2与N2组比较及E1与N1组比较,MUA、hs-CRP、UET、SET、ΔD%、ΔD1%差异有统计学意义(P均<0.05);N2与N1组比较hs-CRP、UET和SET差异有统计学意义(P均<0.05);E2与E1组比较MUA、hs-CRP、UET和SET差异有统计学意义(P均<0.05)。结论 IFG+IGT患者大血管和微血管内皮功能均出现异常,尤以肥胖者为著;患者的代谢功能亦出现异常,主要表现为高血压、高血糖、脂代谢紊乱、胰岛素抵抗及胰岛分泌功能下降。
目的:觀察空腹血糖受損併糖耐量受損( IFG+IGT)患者血管內皮功能及代謝功能情況。方法選擇IFG+IGT者72例( E組),其中非肥胖30例( E1組),肥胖42例( E2組);另選擇糖耐量正常的健康人群142例( N組),其中非肥胖75例( N1組)、肥胖67例( N2組)。做口服葡萄糖耐量試驗及胰島素釋放試驗檢測血糖、免疫活性胰島素,同時檢測空腹血脂、遊離脂肪痠、脂聯素。採用免疫比濁法檢測超敏C反應蛋白( hs-CRP),RIA法檢測血清內皮素( SET)。留取晨尿,採用未抽提法測定內皮素( UET),散射比濁法檢測尿微量白蛋白( MUA)。觀察血壓和腰圍。綵超測定肱動脈休息時、加壓及服用硝痠甘油後的內徑變化,計算內皮依賴性血管舒張功能( EDD)及內皮非依賴性血管舒張功能( EID)指標(ΔD%、ΔD1%)。結果校正性彆、年齡後,E和N組比較、E2與N2組比較及E1與N1組比較,MUA、hs-CRP、UET、SET、ΔD%、ΔD1%差異有統計學意義(P均<0.05);N2與N1組比較hs-CRP、UET和SET差異有統計學意義(P均<0.05);E2與E1組比較MUA、hs-CRP、UET和SET差異有統計學意義(P均<0.05)。結論 IFG+IGT患者大血管和微血管內皮功能均齣現異常,尤以肥胖者為著;患者的代謝功能亦齣現異常,主要錶現為高血壓、高血糖、脂代謝紊亂、胰島素牴抗及胰島分泌功能下降。
목적:관찰공복혈당수손병당내량수손( IFG+IGT)환자혈관내피공능급대사공능정황。방법선택IFG+IGT자72례( E조),기중비비반30례( E1조),비반42례( E2조);령선택당내량정상적건강인군142례( N조),기중비비반75례( N1조)、비반67례( N2조)。주구복포도당내량시험급이도소석방시험검측혈당、면역활성이도소,동시검측공복혈지、유리지방산、지련소。채용면역비탁법검측초민C반응단백( hs-CRP),RIA법검측혈청내피소( SET)。류취신뇨,채용미추제법측정내피소( UET),산사비탁법검측뇨미량백단백( MUA)。관찰혈압화요위。채초측정굉동맥휴식시、가압급복용초산감유후적내경변화,계산내피의뢰성혈관서장공능( EDD)급내피비의뢰성혈관서장공능( EID)지표(ΔD%、ΔD1%)。결과교정성별、년령후,E화N조비교、E2여N2조비교급E1여N1조비교,MUA、hs-CRP、UET、SET、ΔD%、ΔD1%차이유통계학의의(P균<0.05);N2여N1조비교hs-CRP、UET화SET차이유통계학의의(P균<0.05);E2여E1조비교MUA、hs-CRP、UET화SET차이유통계학의의(P균<0.05)。결론 IFG+IGT환자대혈관화미혈관내피공능균출현이상,우이비반자위저;환자적대사공능역출현이상,주요표현위고혈압、고혈당、지대사문란、이도소저항급이도분비공능하강。
Objective To investigate the vascular endothelial function and metabolic function in patients with im-paired fasting glucose combining impaired glucose tolerance( IFG+IGT) .Methods 72 cases of IFG+IGT( group E) in-cluding 42 cases of obesity(group E2)and 30 cases of no-obesity(group E1) were compared to 142 cases of normal glucose tolerance(group N) including 67cases of obesity(groupN2) and 75 cases of no-obesity(group N1).Glucose and insulin were detected in all cases by oral glucose tolerance test and insulin release test.Fasting venous blood of all samples were obtained to measure fasting lipid-related indicators by automatic biochemical analyzer.Serum endothelin-1(SET) was de-tected by RIA and high-sensitivity C-reactive protein( hs-CRP) was detected by immunoturbidimetry.The urine endothelin-1( UET) was tested by no extract direct method of RIA, and urea-microalbumin( MUA) was tested by nephelometry after collecting urina sanguinis.The brachial artery diameter at basal( Db) , reactive hyperemic( Dh) and sublingual nitroglycer-in( Dn) conditions were measured by color Doppler ultrasound respectively.The blood pressure and waist, calculated endo-thelium-dependent vasodilatation ( EDD, ΔD%) and endothelium-independent vasodilatation ( EID, ΔD1%) were also measured respectively.Results The differences of MUA, Hs-CRP, SET, UET,ΔD%andΔD1%after adjusting for sex and age were all significant between group E and group N, group E2 and group N2, group E1 and group N1 ( all P<0.05).It was significant difference between group N2 and group N1 in Hs-CRP, SET and UET(all P<0.05).It was also significant difference between group E2 and group E1 in MUA, Hs-CRP, SET and UET(all P<0.05).Conclusions The impaired endothelial function which occures in macrovascular and microvascular is found in the patients with IFG and IGT and it is serious in the cases of obese patients.The patients with IFG and IGT occure metabolic dysfunction mainly inclu-ding hypertension, hyperglycemia, dyslipidemia, insulin resistance and decline of insulin secretion.