影响2型糖尿病患者动脉硬化的多因素分析

Analysis of the Factors Influencing Artery Atherosclerosis of Type 2 Diabetic Patients

目的探讨2型糖尿病(T2DM)患者动脉硬化的危险因素。方法选取T2DM住院患者164例,通过流式细胞术检测血浆内皮细胞微粒(EMP)水平及超声测定颈动脉内膜中膜厚度(IMT),收集相关临床指标,采用多因素LR Logistic回归分析2型糖尿病患者动脉硬化的危险因素。结果根据超声测定IMT值分两组,T2DM伴颈动脉硬化(CAS)组(120例),T2DM无CAS组(44例)。与T2DM无CAS组比较,T2DM伴CAS组年龄较大,糖尿病病程较长(P<0.01),EMP、糖化血红蛋白、低密度脂蛋白胆固醇(LDLC)、体质指数(BMI)水平升高(P<0.05)。多因素LR Logistic回归分析显示EMP、LDLC、BMI是CAS独立危险因素(EMP OR=1.382,P=0.023;LDLC OR=5.992,P=0.050;BMI OR=1.837,P=0.017)。结论 2型糖尿病患者的EMP、LDLC、BMI与IMT增厚有关,为动脉硬化的独立危险因素,可用于预测、评估其大血管病变风险。

Aim To explore the influence factors on atherosclerosis disease of type 2 diabetes mellitus（ T2DM）. Methods To investigate 164 cases of type 2 diabetes mellitus resident patients,flow cytometry was used to detect the plasma level of endothelial microparticles（ EMP）,ultrasonic was applied to measure the carotid intima-media thickness（ IMT） and collect the relevant clinical indexes,risk factors of atherosclerosis in patients with type 2 diabetes were analyzed by multiple factor LR Logistic regression. Results According to the ultrasonic measurement of IMT they were divided into two groups,T2DM with carotid atherosclerosis group（ 120 cases）; T2DM without carotid atherosclerosis group（ 44 cases）. Compared with T2DM without carotid atherosclerosis group,age was older,duration of diabetes were longer（ P〈0. 01） and EMP,glycosylated hemoglobin A1（ HbA1c）,low density lipoprotein cholesterol（ LDLC）,body mass index（ BMI） levels were higher in T2DM with carotid atherosclerosis（ P〈0. 05）. Multiple factor LR Logistic showed EMP, LDLC,BMI were independent risk factors of carotid atherosclerosis（ EMP OR = 1. 382,95% CI = 1. 046 ~ 1. 826,P = 0. 023）. Conclusion EMP,LDLC,BMI were associated with IMT thickening in patients with type 2 diabetes,as the independent risk factors for atherosclerosis,can be used to predict and evaluate the risk of major vascular lesions.