| Summary: | 碩士 === 東海大學 === 化學工程學系研究所 === 86 === In this study two specific aims were investigated, one is to compare theflow-mediated brachial artery vasoactivity between diabetic patients with orwithou coronary artery disease （CAD）the other is to understand the effect of simvastatin treatment on flow-mediated brachial artery vasoactivity in diabetic patients with hypercholesterolemia. Flow-mediated brachial artery vasoactivity has been recently proposed as a noninvasive means for assessing endothelial function . To better characterize this technique ,we measured the diameter of brachial artery and flow velocity with Doppler at baseline , using 7.5-MHz ultrasound following 5 min of upper arm blood pressure cuff occlusion , after nitroglycerin administration and after ice water hand immersion in 2 1 normal volunteers , 25 patients with non-insulin dependent diabetes mellitus （NIDDM） and 22 NIDDM patients with angiographically documented CAD. After reperfusion , the mean diameter did not differ significantly ,the mean blood flow changes of brachial artery 649±49﹪, 519±58﹪ and 716±82﹪among normals , NIDDM and NIDDM with CAD patients , respectively（p=NS）. The mean diameter of brachial artery and the flow of these three groups were also insignificantly different after NTG administration. During ice water hand immersion stimulation ,the mean diameter of brachial artery increased 0.20±2.04﹪in normal subjects，decreased -2.20±3.58﹪in the NIDDM subjects and -0.61±2.36﹪in the NIDDM with CAD subjects（p=0.0187）. In addition , to determine the effect of cholesterol lowering on endothelial functions , we assessed flow-mediated brachial artery vasoactivity before ,during ,and after simvastatin treatment（10mg/day）in 26 NIDDM patients with hypercholesterolemia. Despite that fasting plasma cholesterol fell from 239±4 to 194±7 ,187±8 and 182±5 mg/dL （p＜0.0001）, LDL-C fell from 157±5 to 114±6 ,108±7 and 106±5 mg/dL（p＜0.0001） , TG fell from 184±16 to 171±16,171±16 and 143±14 mg/dL（p＜0.01） ,after 1,3 and 6 months ,respectively , of treatment , flow-mediated brachial artery vasoactivity did not change significantly.
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