2型糖尿病颈动脉内膜中层病变及相关危险因素分析

Study of carotid intima-media lesions and risk factors in patients with type 2 diabetes mellitus

目的:分析2型糖尿病患者颈动脉内膜中层厚度(CIMT)及其相关危险因素。方法:采用彩色多普勒超声仪测量115例2型糖尿病患者CIMT,并根据CIMT值将全部患者分为A组和B组,其中,A组患者62例,CIMT值≥1.0 mm,B组患者53例,CIMT值<1.0 mm,比较两组血糖、血压和血脂等代谢指标,并对与2型糖尿病CIMT增厚的相关危险因素进行评估。结果:A组患者的年龄、糖尿病病程、高血压病程、低密度脂蛋白胆固醇(LDL-C)、体重指数(BMI)明显高于B组,差异均有统计学意义(均P<0.05),而两组三酰甘油、总胆固醇、高密度脂蛋白胆固醇、糖化血红蛋白、空腹血糖、餐后2小时血糖水平差异无统计学意义(P>0.05)。经Logistic回归分析显示,年龄、糖尿病病程、BMI、LDL-C水平是2型糖尿病患者CIMT增厚的独立相关危险因素(OR=1.093、1.088、1.038、1.732,均P<0.01)。结论:2型糖尿病患者CIMT增厚受多种因素影响,尤其与年龄、肥胖、糖尿病病程和LDL-C水平密切相关。

Objective： To investigate the carotid intima-media thickness （CIMT） and the related risk factors in patients with type 2 diabetes mell^tus. Methods： CIMT of 115 cases of patients with type 2 diabetes were measured by B-mode ul- trasonography. Then all patients were divided into two groups by the value of CIMT. 62 cases were in group A with CIMT≥ 1.0 mm and 53 cases were in group B with CIMT〈1.0 mm. Levels of plasma glucose, blood pressure, blood lipids were measured in all patients, and the related risk factors were assessed by logistic regression analysis. Results： Age, course of diabetes, course of hypertensive, BMI and LDL-C were higher of group A than those of group B, the differences were significant （all P〈0.05）. Values of TG, TC, HDL-C, HBAlc, FBG, 2hPG were compared between the two groups, the differences were not significant （all P〉0.05）. By stepwise logistic regression analysis, age, course of diabetes, BMI and LDL-C were all independently correlated with CIMT（OR=1.093, 1.088, 1.038, 1.732, all P〈0.01）. Conclusion： CIMT bodi- ness is influenced by various kinds of factors, and which is highly associated with age, BMI, course of diabetes and LDL-C in patients with type 2 diabetes mellitus.