探讨不同干预措施对老年2型糖尿病患者脑血管储备(CVR)能力的影响。

选取老年2型糖尿病患者60例及正常健康体检老年自愿者60例(对照组)。糖尿病组根据治疗方法不同分为康复锻炼组、丁苯酞治疗组、盐酸氟桂利嗪治疗组，每组20例，治疗时间均为6个月。对所有受试者利用经颅多普勒超声结合屏气试验评估颅内血管反应，计算屏气指数(BHI)对CVR进行评价。各组患者治疗前后BHI的比较采用配对t检验。

糖尿病患者治疗前BHI为0.49±0.08，对照组BHI为0.55±0.05，差异有统计学意义(t＝－5.49，P<0.01)。治疗后，康复锻炼组和盐酸氟桂利嗪治疗组BHI均无明显变化，与治疗前比较差异无统计学意义(0.50±0.08、0.56±0.09，0.49±0.07、0.53±0.08；t＝－1.38、－1.34，P>0.05)；而丁苯酞治疗组BHI明显增高，与治疗前比较差异有统计学意义(0.54±0.07，0.50±0.08；t＝1.72，P＝0.01)。

老年2型糖尿病患者的CVR较正常老年人下降，给予丁苯酞治疗可以适当改善老年2型糖尿病患者的脑血管储备能力。

To explore the cerebrovascular reserve in the type 2 diabetel mellitus (T₂DM) by transcranial doppler sonography (TCD) combined with breathholding test(BHT) and to explore the changes of the cerebrovascular reserve after the patients received the different interventions.

Sixty elderly T2DM and 60 health controls were selected. The clinical data about the breath-holding index were collected. The diabetics were randomly divided into three groups: the rehabilitation exercise group (n=20), the NBP group (n=20) and the Flunarizine hydrochloride group (n=20). Each group has received the corresponding treatment for six months.All patients were valued by TCD combined with BHT to evaluate intracranial vascular reaction and then the breath-holding index (BHI) were calculated.

Before the treatment, there was a statistically significant difference between thediabetic group (BHI 0.49±0.08) and the control group (BHI 0.55±0.05) (t=-5.59, P<0.01). After the treatment, BHI of the rehabilitation exercise group and the Flunarizine hydrochloride group had no change, and there was no statistically significant difference comapared with that before the treatment (0.50±0.08, 0.56±0.09 and 0.49±0.07, 0.53±0.08, t=-1.38、-1.34, P>0.05), while the NBP group had an significant increasing trend (0.54±0.07, 0.50±0.08, t=1.72, P=0.01).

The cerebrovascular reserve in the aged diabetics are declined. The NBP may improve the cerebrovascular reserve of diabetics.