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胰岛素治疗对Ⅱ型糖尿病并发冠心病患者的冠状动脉微循环灌注和粥样硬化斑块的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第1期
页码:
68-71
栏目:
临床研究
出版日期:
2010-01-04

文章信息/Info

Title:
Effect of insulin treatment on coronary microcirculatory perfusion and atherosclerosis plaque in patients with type II diabetes mellitus and coronary artery disease
作者:
金泽宁1吕树铮1陈韵岱2苑飞1宋现涛1吴小凡1张丽洁1
1.首都医科大学附属北京安贞医院心内科,北京市心肺血管疾病 研究所,北京 100029;2.解放军总医院心内科,北京 100853
Author(s):
JIN Ze-ning1LüShu-zheng1CHENYun-dai2YUANFei1SONGXian-tao1WU Xiao-fan1ZHANG Li-jie1
1.Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessels, Beijing 100029, China; 2.Division of Cardiology, Internal Medicine, PLA General Hospital, Beijing 100853, China
关键词:
糖尿病冠状动脉疾病胰岛素心肌梗死溶栓试验血流校正帧数
Keywords:
diabetes mellitus coronary disease insulin corrected TIMI frame counts
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的: 探讨胰岛素治疗对糖尿病并发冠心病患者微循环灌注和斑块的影响。方法: 明确诊断糖尿病并发冠心病患者62例,行定量冠状动脉造影(QCA)和血管内超声检查(IVUS)。按目前是否使用胰岛素分为:单纯口服降糖药组和口服降糖药联合使用胰岛素组。对比两组患者不同性别3支血管的心肌梗死溶栓试验(TIMI)校正帧数(CTFC)结果,来评价冠脉血流灌注。同时对比两组患者的IVUS斑块特征。结果: 两组患者的斑块无论是在体积,形态和组成成分方面差别均无统计学意义的差别。合用胰岛素组患者无论性别,3支血管的CTFC帧数均要少于单纯口服药物组。差别有统计学意义(P<0.05)。结论: 在Ⅱ型糖尿病并发冠心病患者中,注射胰岛素对于改善冠脉血流速度有明显影响。但对已经存在的动脉粥样斑块没有影响。
Abstract:
AIM: To explore the effect of insulin treatment on coronary perfusion and atherosclerosis plaque. METHODS: A total of 62 patients with type II diabetes mellitus and coronary artery disease (CAD) underwent coronary angiography (CA) and intravascular ultrasound (IVUS) tests. Patients were divided into two groups according to insulin injection. We compared corrected TIMI frame counts (CTFC) and IVUS morphologic status between groups. RESULTS: There was no difference between groups in terms of plaque volume, morphology and composition. CTFC were less in insulin group regardless of gender and vessels (P<0.05). CONCLUSION: Insulin treatment improves coronary perfusion by improvement of endothelial cell function but has no positive effect on well-formed atherosclerosis plaques.

参考文献/References

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[6] 余叶蓉. 胰岛素的血管活性作用及其与内皮细胞功能的关系[J]. 中华内分泌代谢杂志, 2002, 18(4):323-325.

[7] Lind L, Fugmann A, Branth S, et al. The impairment in endothelial function by non-esterfied fatty acids can be reversed by insulin[J]. Clin Sci, 2000, 99(3):169-174.

[8] Kuboki K, Jiang ZY, Takahara N, et al. Regulation of endothelial constitutive nitric oxide synthase gene expression in endothelial cells and in vivo: a specific vascular action of insulin[J]. Circulation, 2000, 101(6):676-681.

[9] 郑莺,刘建平. 糖尿病致冠状动脉粥样硬化的机制[J]. 心脏杂志, 2007, 19(3):347-350.

备注/Memo

备注/Memo:
收稿日期:2009-1-20.基金项目:北京市科委高科技战略主题计划项目资助 (D0906006040191);北京市科技新星计划项目资助(2006B01) 通讯作者:吕树铮,主任医师,主要从事急性冠脉综合征的临床和基础研究Email:shuzheng@medmail.com.cn 作者简介:金泽宁,副主任医师,博士jinzening@hotmail.com
更新日期/Last Update: 2010-01-05