中文摘要：

目的 通过比较糖尿病及非糖尿病冠状动脉旁路移植术（CABG）患者的桡动脉形态学及血管内皮生长因子（VEGF）表达水平的变化,评价糖尿病患者桡动脉的质量及影响其CABG远期通畅率的可能因素.方法 利用前瞻性分析的方法对2009年6月至2010年12月20例糖尿病组及20例非糖尿病组CABG患者的桡动脉形态学进行观察,利用HE染色对比两组患者桡动脉的内膜增厚情况,并通过Western blot法及免疫荧光对两组患者桡动脉中VEGF表达量及定位情况进行比较.结果 糖尿病组桡动脉内皮增厚指数及内膜/中膜比高于非糖尿病组,分别为0.90±0.28比0.29±0.25（t =7.27,P＜0.01）及0.90 ±0.21比0.37 ±0.18（t=8.57,P＜0.01）.糖尿病组桡动脉VEGF表达水平明显高于非糖尿病组,其与内参照的灰度值比值为1.20 ±0.21比0.67 ±0.15（t =6.49,P＜0.01）,主要定位于糖尿病组患者桡动脉内皮细胞的细胞质中.结论 糖尿病患者桡动脉内膜层厚度明显高于非糖尿病患者,VEGF可能与糖尿病组患者桡动脉内膜层增厚有关.糖尿病患者应慎重选择桡动脉作为CABG桥血管.

英文摘要：

Objective To evaluate the quality of the radial artery for coronary artery bypass grafting （CABG） from patients with diabetes by observing the morphology of the radial artery and detecting the expression of vascular endothelial growth factor （VEGF） which may attribute to the long-term patency rate of the coronary artery bypass grafting. Methods Samples from 20 cases of diabetic and non-diabetic patients were prospective collected from June 2009 to December 2010. HE staining technique was used to test the morphology of radial artery through the observation of 20 cases of diabetic and 20 cases of non-diabetic patients who undergone CABG. The intimal thicken of the radial artery in the two groups of patients was compared. Western blot and immunofluorescenee were then used to test the expression and location of VEGF in the two groups of patients. Results The radial artery endothelial thickening index and intima/media ratio were significantly higher in the diabetic patients when compared with non-diabetic patients （0. 90 ±0. 28 vs. 0.29±0.25, t=7.27,P〈0.01; 0.90±0.21 vs. 0.37±0.18, t=8.57,P〈0.01）. The expression of VEGF in diabetic patients was significantly higher than non-diabetic patients as revealed by Western blot （ 1.20±0. 21 vs. 0. 67 ±0. 15, t =6.49 ,P 〈0. 01 ）. Immunofluorescenee showed that VEGF distributed in the cytoplasm of the endothelial cells of diabetic patients radial artery. Conclusions Diabetic patient＇s radial artery intimal thickness is significantly higher than non-diabetic patient＇s. VEGF may be an important inflammatory eytokine which is leading the radial artery intima thickening in the diabetic patients. The choice of the radial artery grafts in diabetic patients for CABG should be careful.