翻译：安丽 编辑：冯玉蓉 审校：曹莹
结果：在高强度运动时，与对照组相比，糖尿病患者中PTAC水平较低的人数更多(41% vs. 12.5%, χ2 P = 0.041)，尤其是与无并发症的糖尿病患者和对照组相比，有微血管并发症的糖尿病患者PTAC水平较低的人数更多 (55% vs. 26% vs. 13%, χ2 P = 0.02)。糖尿病患者和对照组的年龄(44 ±13 vs. 43 ±13岁, P = 0.87) 和性别(70% vs. 65%男性, P = 0.7)组成相似。与高PTAC相比，低PTAC与运动期间VO2peak降低24% (P = 0.006)、右心室功能降低(P = 0.015)和肺动脉压增大 (P = 0.02)有关。
原始文献：Roberts TJ, Burns AT, MacIsaac RJ, et al. Diagnosis and Significance of Pulmonary Microvascular Disease in Diabetes.[J].Diabetes Care 2018 04;41(4):854-861.
Diagnosis and Significance of Pulmonary Microvascular Disease in Diabetes
To determine whether pulmonary microvascular disease is detectable in subjects with diabetes and associated with diminished exercise capacity using a novel echocardiographic marker quantifying the pulmonary transit of agitated contrast bubbles (PTAC).
RESEARCH DESIGN AND METHODS
Sixty participants (40 with diabetes and 20 control subjects) performed cardiopul-monary (maximal oxygen consumption [VO2peak]) and semisupine bicycle echocar-diography exercise tests within a 1-week period. Pulmonary microvascular disease was assessed using PTAC (the number of bubbles traversing the pulmonary circulation to reach the left ventricle, categorized as low PTAC or high PTAC). Echocardiographic measures of cardiac output, pulmonary artery pressures, and biventricular function were obtained during exercise.
At peak exercise, low PTAC was present in more participants with diabetes than control subjects (41% vs. 12.5%, χ2 P = 0.041) and, in particular, in more subjects with diabetes with microvascular complications compared with both those without complications and control subjects (55% vs. 26% vs. 13%, χ2 P = 0.02).Subjects with diabetes and control subjects were of similar age (44 ±13 vs. 43 ±13 years, P = 0.87) and sex composition (70% vs. 65% male, P = 0.7).When compared with high PTAC, low PTAC was associated with a 24% lower VO2peak (P = 0.006), reduced right ventricular function (P = 0.015), and greater pulmonary artery pressures during exercise (P = 0.02).
PTAC is reduced in diabetes, particularly in the presence of microvascular pathology in other vascular beds, suggesting that it may be a meaningful indicator of pulmonary microvascular disease with important consequences for cardiovascular function and exercise capacity.