糖尿病患者颈动脉彩色多普勒超声检测与血脂的关系分析

Evaluation of correlations between hyperlipidermia and carotid arthrosclerosis manifestations by color doppler ultrasonograhy in diabetic patients

目的探讨糖尿病患者血脂的改变与颈动脉血管并发症的关系。方法糖尿病患者150例为糖尿病组,年龄60-89岁。106例同期健康体检者为对照组,年龄60-88岁。受试者均测定空腹血压、血糖、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、极低密度脂蛋白(VLDL)、载脂蛋白AI和载脂蛋白B(ApoA1、ApoB)同时行彩色多普勒颈动脉超声检查。结果(1)糖尿病组血糖、TC、TG、VLDL、ApoB[(176.81±58.63)mg/d l、(202.67±42.26)mg/d l、(206.56±145.52)mg/d l、(33.32±32.47)mg/d l、(99.30±34.20)mg/d l]水平明显高于对照组[(125.45±1.58)mg/d l、(176.10±47.17)mg/d l、(116.5±60.43)mg/d l、(22.04±11.44)mg/d l、(80.5±22.70)mg/d l],两组比较差异有显著性(P<0.05)。糖尿病组纤维蛋白原为(4.675±1.643)g/L对照组为(3.238±1.065)g/L,糖尿病组纤维蛋白明显高于对照组(P<0.01)。(2)糖尿病患者的颈动脉超声显示颈动脉血管壁回声不均匀,内中膜增厚,可有多支血管斑块形成及不同程度的狭窄。结论脂代谢异常是血管并发症形成的危险因素,颈动脉粥样硬化斑块是糖尿病患者早期主要血管病变表现之一,颈动脉超声能及早提示糖尿病患者的血管病变程度,为治疗和预防提供依据。

Objective To evaluate the correlation of hyperlipidemia and carotid arthrosclerosis manifestations by color Doppler uhrasonography diabetic patients. Methods 150 diabetic patients and 106 normal subjects were enrolled in the study. The manifestation of carotid by color Doppler uhrasonography and blood laboratory examination including blood sugar, TC, TG, HDL, ApoB ,VLDL, ApoA1 , ApoB were compared between two groups. Results The laboratory paremeters, including the blood sugar, TC, TG, HDL, ApoB, VLDL, ApoA1 , ApoB were increased in diabetic patients than those in normal subjects （P 〈0.05）. The thickness of intima-media （IMT） of carotid were increased more significantly, arteries narrowing and wall plaque also were found more than those in normal subjects. Conclusions The arteriosclerosis plaque is one of early vessel lesion manifestations in elderly diabetic patients and hyperlipidemia may be the basis of it. The dopper uhrasonography of carotid can show the arteriosclerosis manifestations and offer the basic data for clinical treatment.