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目的探讨糖尿病性肾脏疾病(DKD)IV期患者的血管内皮功能及其影响因素。方法选取2006—2008年在我院住院的T2DM肾病IV期患者70例,记录病程,检测FPG、FIns、HbA1c、血脂,超声测定肱动脉血管内径、基础血流、内皮依赖性血管舒张功能及硝酸甘油介导的血管舒张功能,99mTc-二乙三胺五乙酸ECT法测定肾小球滤过率(GFR),并与同期住院的30例无微血管并发症的T2DM患者(对照组)进行比较。结果 DKD IV期患者内皮依赖性血管内径变化为(2.93±0.73)%,低于对照组,其变化与HDL-C、HOMA-β、GFR呈正相关,与饮食中蛋白质含量、糖尿病病程、HbA1c、24hUAlb、HOMA-IR呈负相关。结论 DKD IV期已存在明显的内皮功能受损,高蛋白饮食是其重要的影响因素之一。
Objective To investigate the vascular endothelial function and its influencing factors in stage IV diabetic nephropathy (DKD). Methods Seventy patients with T2DM nephropathy who were hospitalized in our hospital from 2006 to 2008 were enrolled in this study. The course of disease, FPG, FIns, HbA1c and lipids were recorded. The brachial artery diameter, basal blood flow, endothelium-dependent vasodilatation and nitric acid Glycerol-mediated vasodilation, and GFR was measured by 99mTc-diethylenetriaminepentaacetic acid ECT and compared with 30 hospitalized T2DM patients without microvascular complications (control group). Results The endothelium-dependent vascular diameter of patients with DKD stage IV was (2.93 ± 0.73)%, which was lower than that of the control group. The changes were positively correlated with the levels of HDL-C, HOMA-β and GFR, 24hUAlb, HOMA-IR was negatively correlated. Conclusion DKD IV stage has obvious endothelial dysfunction, high protein diet is one of the important factors.