缺血性脑血管病患者颈动脉病变与糖代谢的关系

Relationship between carotid artery lesions and glucose metabolism in patients with ischemic cerebrovascular disease

目的探讨缺血性脑血管病（ICVD）患者颈动脉病变与糖代谢的关系。方法 122例ICVD患者根据葡萄糖耐量试验（OGTT）结果分为糖耐量正常（NGT）组（44例）、糖耐量减低（IGT）组（27例）及糖尿病（DM）组（51例）,对各组患者进行颈动脉彩色多普勒超声检查,并对3组间颈动脉病变情况进行分析。结果 DM组年龄明显高于NGT组（P〈0.05）,IGT组三酰甘油（TG）水平明显高于NGT组（P〈0.05）。3组间负荷后血糖峰值差（PGS）、0-120 min血糖-时间曲线下面积（AUC0-120）、OGTT 2 h血糖水平差异有统计学意义（均P〈0.01）。DM组和IGT组颈动脉粥样斑块不稳定性及管腔狭窄发生率高于NGT组（均P〈0.05）。糖耐量异常的ICVD患者颈动脉狭窄程度与AUC0-120、负荷后血糖最大值（PGmax）及PGS呈正相关（r=0.231,r=0.168,r=0.191;均P〈0.05）。结论 ICVD患者随糖代谢异常程度增加,其颈动脉的病变程度加重。

Objective To investigate the relationship between carotid artery lesions and glucose metabolism in patients with ischemic cerebrovascular disease（ICVD）.Methods 122 ICVD patients were divided into normal glucose tolerance（NGT） group（44 cases）,impaired glucose tolerance（IGT） group（27 cases） and diabetes mellitus（DM） group（51 cases） by oral glucose tolerance test（OGTT）.Patients in the 3 groups were examined by color doppler diagnosis apparatus,and the carotid artery lesions were analyzed.Results Age of DM group was older than NGT group（P0.05）.The differences between postprandial glucose spike（PGS）,area under plasma glucose level-time curve from 0 to 120 min（AUC0-120） and 2 h postprandial plasma glucose（2 h PG） during OGTT among the 3 groups were significant（all P0.01）.The plague instability and incidence of stegnosis in carotid artery lesions in DM group and IGT group were significantly higher than those in NGT group（all P0.05）.The AUC0-120,PGmax and PGS were positive correlation with extent of carotid artery stegnosis in ICVD patients with IGT（r=0.231,r=0.168,r=0.191;all P0.05）.Conclusion With glucose metabolism abnormity aggravate,the extent of carotid artery lesions increased in patients with ICVD.