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目的检测2型糖尿病(T2DM)、糖耐量异常(IGT)、空腹血糖受损(IFG)患者肱动脉内皮功能的变化与血小板活化程度的关系。方法分别选取老年T2DM(T2DM组)、IGT(IGT组)、IFG(IFG组)患者和健康体检者(对照组)各20例,空腹静脉血测定空腹血糖(FPG)、TG、TC、HDL-C、LDL-C、糖化血红蛋白(HbA1c)、血小板膜糖蛋白CD61和CD62P。采用高分辨率血管外彩色超声测定肱动脉血流介导的血管扩张功能(FMD)和含服硝酸甘油后肱动脉内径变化(NTG)。结果 T2DM组、IGT组、IFG组FMD较对照组明显下降,而T2DM组NTG较IGT组、IFG组、对照组明显下降(P<0.05)。多因素线性相关分析,FMD与FPG、TG、TC、LDL-C呈负相关。T2DM组、IGT组、IFG组CD61和CD62P较对照组明显升高(P<0.05)。CD61与FPG、TC、HbA1c、LDL-C呈正相关,与HDL-C呈负相关;CD62P与FPG、TG、TC、HbA1c、LDL-C呈正相关,与HDL-C呈负相关。FMD与CD61、CD62P呈负相关。结论内皮功能损害和血小板活化在T2DM前期就已经存在,两者互相促进。
Objective To investigate the relationship between changes of endothelial function in brachial artery and platelet activation in type 2 diabetes mellitus (T2DM), impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). Methods Fasting blood glucose (FPG), fasting blood glucose (TG), high blood lipids (TC) and HDL-C were measured in 20 T2DM patients, IGT patients, IFG patients and healthy volunteers, C, LDL-C, glycosylated hemoglobin (HbA1c), platelet membrane glycoproteins CD61 and CD62P. Brachial artery-mediated vasodilation (FMD) and change in brachial artery diameter (NTG) after nitroglycerin administration were measured by high resolution extracorporeal color ultrasound. Results The levels of FMD in T2DM, IGT and IFG groups were significantly lower than those in control group, while NTG in T2DM group was significantly lower than that in IGT group, IFG group and control group (P <0.05). Multivariate linear correlation analysis, FMD and FPG, TG, TC, LDL-C was negatively correlated. The levels of CD61 and CD62P in T2DM, IGT and IFG groups were significantly higher than those in control group (P <0.05). CD61 was positively correlated with FPG, TC, HbA1c and LDL-C, but negatively correlated with HDL-C. CD62P was positively correlated with FPG, TG, TC, HbA1c and LDL-C and negatively correlated with HDL-C. FMD was negatively correlated with CD61 and CD62P. Conclusion Endothelial dysfunction and platelet activation existed in the early stage of T2DM, and the two promoted each other.