2型糖尿病纤维蛋白原与颈动脉及股动脉内膜关系的研究

The study of correlationship between fibrinogen and intimar media thickness of carotid and femoral arteries in Type 2 Diabetes Mellitus

目的探讨2型糖尿病(T2DM)高纤维蛋白原(FIB)血症与颈动脉内膜厚度(CAIM T)、股总动脉内膜厚度(FAIM T)及斑块累及的相关性。方法用高分辨率彩色多普勒超声测定164例2型糖尿病病人及60例健康者(对照组)的CAIM T、FAIM T,同时测定凝血象、血脂等9项指标,并进行统计学分析。结果2型糖尿病患者CAIM T≥0.09cm组与CAIM T<0.09cm组比较内膜厚度(IM T)与FIB、CH O、TG、LDL、年龄、DM病程(P<0.01)、高血压病程(P<0.05)呈正相关,与H DL、凝血酶时间(PT)呈负相关(P<0.01);FAIM T≥0.10cm组与FAIM T<0.10cm组结果与颈动脉组相似;两组DM组较正常对照组IM T均明显增厚(P<0.01),DM高FIB组较DM正常FIB组CAIM T、FAIM T均增厚(P<0.01),且上下肢均累及的比例增加(P<0.05)。结论2型糖尿病合并高FIB水平大动脉内膜增厚更明显,FIB升高是2型糖尿病动脉硬化、斑块形成的危险因素。

Objective To investigate the correlationship of carotid artery intima-media thickness(CAIMT),femoral artery intima-media thickness(FAIMT), involvement plaque and hyperfibrinogenemia in type 2 diabetes(T2DM).Methods Measured the CAIMT and FAIMT with a high resolution color doppler ultrasonography in 164 patients with type 2 diabetes and 60 matched healthy controls,and observed coagulative factors, serum lipids etc. Results In T2DM,CAIMT was positively related with FIB,CHO,TG, LDL,age(P<0.01), duration of DM(P<0.01) and hypertension(P<0.05), negatively related with HDL,PT(P<0.01) between the group of CAIMT≥0.09cm and CAIMT<0.09cm, this result was also similar between the group of FAIMT≥0.10cm and FAIMT<0.10cm. In two T2DM groups,CAIMT and FAIMT were thicker than health control guroup(P<0.01).Compared with the nomal level FIB diabetes group, in high level FIB diabetes group, the CAIMT and FAIMT were thicker(P<0.01).The proportion that the carotid artery and the femoral artery involved was increased(P<0.05).Conclusion The CAIMT and FAIMT are significant thicker in T2DM with hyperfibrinogenemia and the hyperfibrinogenemia is risk factors for atherosclerosis and plaque.