| ObjectiveTo investigate the changes of pulse wave velocity (PWV) and relative index in patients with coronary artery disease (CAD) and diabetes mellitus (DM), and evaluate the effect of drug intervention, as PWV is an simple, effective and repetitive indicator to evaluate the elasticity of arterial blood vessel. This article is to investigate.MethodsThe control group (group A) enrolled50cases suspected with CAD, with exclusion of CAD by coronary arteriongraphy, without DM and with risk factors of arteriosclerosis like smoking history. About100cases were diagnosed with CAD by coronary arteriongraphy, and divided into CAD group (group B) and CAD combined with DM group (group C) according to levels of fasting plasma glucose (FPG) and postprandial blood sugar. Branchio-ankle pulse wave velocity (baPWV) of patients in3groups were detected by arteriosclerosis detect instrument. All patients were measured with height, body weight, blood pressure, FPG,2-hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbAlc), triglyceride (TG), total cholesterol (TG), high density lipoprotein cholesferol (HDL-C), low density lipoprotein-cholesterol (LDL-C), high sensitive C-reactive protein (hs-CRP), nitric oxide (NO) endothelin (ET) and body mass index (BMI). The differences of baPWV and above indicators in group C were compared with other groups. Relation of baPWV with above indicators in group C was analyzed. Under standard treatment, intervention of life style, the patients in group C were given melbine and gliclazide retard tablets. After6months, the changes of above indicators were compared between before and after drug application, the relation of baPWV changes with changes of other indicators were anlyzed.ResultsIn group C, the levels of FBG,2hPG, HbAlc, TQ LDL-C, hs-CRP, Et and baPWV were obviously hgher than those in group A and group B (P<0.05, P<0.01), but NO level was obviously lower than that in group A and group B (P<0.01). Levels of LDL-C, hs-CRP, ET and baPWV in group B were obviously higher than those in group A (P<0.05, P<0.01), but NO level lower than that in group A (P<0.05). No difference was found in HbAlc between group A and group B (P>0.05), either in age, sex, SBP, DBP, BMI, TC and HDL-C among3groups (P>0.05). In group C, the incidences of triple vessel disease and diffuse disease were higher than those in group B, but incidence of single vessel disease was lower than that in group B, significant differences were found (P<0.05, P<0.01). In group C, baPWV had positive relation with age,2hPG, LDL-C, HbAlc,hs-CRP, ET (P<0.05, P<0.01), had negative relation with NO level (P<0.01), no relation with BMI, SBP, DBP, FPG,TG, TC or HDL-C (P>0.05). After treatment, FBG,2hPG, HbAlc, TG, LDL-C and hs-CRP obviously decreased in group C, there are statistical differences (P<0.05, P<0.01); NO level obviously increased (P<0.01), and no difference was found in baPWV, ET, BMI, SBP and DBP (P>0.05).ConlusionIn DM stage of CAD, insulin resistance plays a major role in arteriosclerosis, the combined effect of hyperglycemia, insulin resistance, endothelium disfunction and inflammation reaction can directly and indirectly injury blood vessel endothelium, accelerate arteriosclerosis, decrease elasticity of arterial blood vessel and increase PWV value. Early detection of PWV, CRP NO and ET in patients with CAD and DM can provide objective evidence for standard drug treatment. For patients with CAD and DM, standard drug treatment at short term can not decrease PWV value and improve elasticity of arteriosclerosis. |
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