达标调脂治疗对新诊断2型糖尿病亚临床动脉粥样硬化进展的影响

Progress of subclinical atherosclerosis of newly diagnosed type 2 diabetic patients with targeted lipid-lowering intervention

目的:探讨以达标为靶目标的调脂治疗对新诊断2型糖尿病(T2DM)患者亚临床动脉粥样硬化(AS)进展的影响。方法:84例病程在1年以内、无AS的T2DM患者,在进行抗血小板聚集、强化血糖、血压达标治疗的基础上,随机分为达标调脂治疗组和对照组,采用高分辨血管外超声方法分别于治疗前及治疗2年后检测颈动脉的内中膜厚度(IMT)及血管内AS斑块情况。结果:治疗2年后两组颈动脉IMT变化差异无显著性(P>0.05),达标调脂治疗组颈动脉内AS斑块发生的比例显著低于对照组(P<0.05)。Logistic回归分析提示是否接受达标调脂治疗是影响颈动脉血管内AS斑块发生的独立危险因素。结论:对新诊断、已经接受强化血糖及血压达标治疗的T2DM患者,进一步采取以达标为靶目标的调脂治疗能有效减少颈动脉内AS斑块的发生。

Objective To explore the progress of subclinical atherosclerosis （AS） of newly diagnosed type 2 diabetic patients undergoing targeted lipid-lowering intervention. Methods Eighty-four diabetic patients （duration ≤ 1 year）without AS were divided into two groups （group A and B） randomly, and group A was designed to undergo targeted lipid-lowing treatment. The two groups were all underwent the targeted intervention including the controlling of blood glucose, blood pressure and taking aspirin as well. Noninvasive high resolution B mode ultrasonography was used to measure the intima medial thickness （IMT） and atherosclerotic plaques of common carotid artery （CCA） at baseline and after 2-year intervention. Results No significant difference of IMT change between two groups （P 〉 0.05）after 2-year, and ratio of AS plaques of CCA in group A was significantly lower than group B （P 〈 0.05）. Logistic stepwise regression analysis showed that ＂if undergo targeted lipid- lowing treatment＂ itself was the independent risk factor for AS plaques development of CCA. Conclusion To newly diagnosed type 2 diabetics have already at intensified blood glucose and blood pressure control, taking further treatment such as targeted lipid-lower intervention will effectively reduce carotid plaques development.