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

Relationship Between Color Doppler Ultrasonography in Arteria Carotis and Blood Lipid in Diabetics Mellitus

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（Apo AI）和载脂蛋白B（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/dl、（202.67±42.26）mg/dl、（206.56±145.52）mg/dl、（33.32±32.47）mg/dl、（99.30±34.20）mg/dl]水平明显高于对照组[（125.45±1.58）mg/dl、（176.10±47.17）mg/dl、（116.5±60.43）mg/dl、（22.04±11.44）mg/dl、（80.5±22.7）mg/dl],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 detect the relationship between the changes of blood lipid and carotid complications in patients with diabetics mellitus.Methods：150 patients with diabetics mellitus aged between 60 and 89 years were selected as diabetics mellitus group and 106 normals aged between 60 and 88 years as contral group.The level of fasting blood pressure,blood sugar,cholesterol,triglyceride（TG）,high density lipoprotein（HDL）,low density lipoprotein（LDL）,vey low density lipoprotein（VLDL）,apolipoprotein A1（ApoAI） and apolipoprotein B（ApoB） were detected and color Doppler ultrasonography in arteria carotis were performed.Results：The levels of blood sugar,cholesterol,TG,VLDL and ApoB were markedly higher diabetics mellitus group than those in control group,the difference was significant（P〈0.05）.The level of fibrinogen in diabetics mellitus was higher than that in control group（P〈0.01）.The image of carotid ultrasound showed asymmetric echo in carotid vascular wall,incrassate inner and media membrane and multiple vascular plaques and different degrees of necrosis in patients with diabetics mellitus.Conclusion： Abnormal lipid metabolism is the risk factor for vascular complications in diabetics mellitus.Carotid artherosclerosis is one of early manifestations of vascular lesions in diabetics mellitus.The carotid ultrasonography can early indict the degrees of vascular lesions and provide evidences for the treatment and prevention of diabetics mellitus.