内中膜厚度定量及动脉僵硬度分析技术评价糖耐量减低及2型糖尿病者颈总动脉改变

Evaluating changes of carotid artery in patients with impaired glucose tolerance and type 2diabetes mellitus with quantitative intima-media thickness and quantitative arterial stiffness

目的应用血管内中膜厚度定量(QIMT)及动脉僵硬度分析(QAS)技术评价糖耐量减低(IGT)和2型糖尿病(T2DM)患者颈总动脉结构及功能的改变。方法对病例组68例患者[30例IGT(IGT亚组)和38例T2DM(T2DM亚组)]及58名正常对照(NC)组的右侧颈总动脉行QIMT、QAS及相关血清学检查,获取以下参数:内中膜厚度(IMT)、顺应性系数(CC)、扩张性系数(DC)、僵硬度参数(β)、2h血糖值(2hPG)、甘油三酯(TG),胆固醇(Ch),低密度脂蛋白(LDL),糖化血红蛋白(GHb),并分析NC组与病例组各亚组之间的差异及相关性。结果 T2DM亚组DC低于NC组(P<0.05),其余参数组间两两比较差异均有统计学意义(P均<0.05);IGT和T2DM亚组β和IMT、2hPG、LDL与GHb均呈正相关(P均<0.01)。结论 QIMT及QAS技术可反映动脉血管的早期结构及功能变化,对诊断IGT及T2DM患者早期动脉粥样硬化具有一定价值。

Objective To investigate the structural and functional changes of carotid artery in patients with type 2 diabetes mellitus （T2DM） and impaired glucose tolerance （IGT） with quantitative intima-media thickness （QIMT） and quantitative arterial stiffness （QAS） technique. Methods The right side of common carotid artery of 68 patients （30 IGT and 38 T2DM ） and 58 healthy controls （NC group） were examined with QIMT, QAS technique and relative serological testing. Parameters including triglyceride （TG）, low-density lipoprotein （ LDL）, cholesterol （Ch）, glycosylated hemoglobin （GHb）, intima-media thickness （IMT）, compliance coefficient （CC）, distensibility coefficient （DC）, stiffness index （6） and 2 h plasma glucose （2hPG） of carotid obtained were acquired and the statistically analyzed. Results DC in T2DM subgroup was lower than in NC group, while the other parameters all had statistical differences among groups （all P〈0.05）. There was positive correlation between β and IMT, 2hPG, LDL, GHb in IGT and T2DM subgroup （all P〈0.01）. Conclusion QIMT and QAS technique are able to detect early structural and functional changes of carotid artery, and have certain value for the early diagnosis of arteriosclerosis in patients with IGT and T2DM.