2型糖尿病患者下肢动脉内膜中层厚度与超敏C反应蛋白及纤维蛋白原的相关性分析

Correlation of Peripheral Arterial Intima- media Thickness with High Sensitive C- reactive Protein and Fibrinogen in T2DM

目的探讨2型糖尿病(T2DM)患者下肢动脉内膜中层厚度(IMT)与超敏C反应蛋白(hs-CRP)及纤维蛋白原(Fg)的相关性。方法选取2010年1—12月在暨南大学第二临床学院内分泌科住院的T2DM患者89例作为T2DM组,选取同期体检中心的健康者85例作为对照组。收集临床资料〔包括年龄、性别、身高、血压(收缩压和舒张压)、腰围、臀围,计算体质指数(BMI)和腰臀比(WHR)〕;检测生化指标〔包括空腹血糖(FPG)、糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、hs-CRP、Fg〕;彩超测量下肢动脉〔股动脉(CFA)及腘动脉(POA)〕IMT。采用Pearson线性相关分析下肢动脉IMT与hs-CRP及Fg的关系。结果两组收缩压和舒张压比较,差异无统计学意义(P>0.05);T2DM组患者的BMI和WHR均高于对照组(P<0.05)。两组TG、TC比较,差异无统计学意义(P>0.05);T2DM组患者的LDL-C、FPG、HbA1c均高于对照组,而HDL-C低于对照组(P<0.05)。T2DM组的hs-CRP、Fg、CFA IMT、POA IMT均高于对照组(P<0.05)。T2DM组患者CFA IMT与POA IMT呈正相关(r=0.461,P<0.05),CFA IMT与hs-CRP、Fg呈正相关(r=0.367、0.456,P<0.05),POA IMT与hs-CRP、Fg呈正相关(r=0.379、0.417,P<0.05)。结论 T2DM患者下肢动脉IMT与hs-CRP及Fg均呈正相关关系,动态监测hs-CRP及Fg有助于早期预测T2DM下肢动脉病变的发生发展,值得临床推广应用。

Objective To assess the association between peripheral arterial intima-media thickness and high sensitive C- reactive protein,fibrinogen in T2 DM. Methods From January to December 2010,89 T2 DM patients（ T2 DM group） hospitalized in department of endocrinology,the Second Affiliated Hospital of Jinan University and 85 healthy subjects（ control group） were enrolled in this study. The clinical data were collected,FPG,HbA1 c,TG,TC,LDL-C,HDL-C,hs-CRP,Fg determined,IMT of CFA and POA measured by color doppler ultrasound. The relationship of IMT with hs- CRP and Fg was analyzed by Pearson linear regression analysis. Results There was no significant difference in SBP,DBP between 2 groups（ P 0. 05）. BMI and WHR were higher in T2 DM group than in control group（ P 0. 05）. There was no difference in TG,TC between 2 groups（ P 0. 05）. LDL- C,FPG,HbA1 cwere higher in T2 DM group than in control group,but HDL- C lower（ P 0.05）. The levels of hs-CRP,Fg,CFA IMT,POA IMT were higher in T2 DM group than in control group（ P 0.05）.CFA IMT was positively correlated with POA IMT（ r = 0. 461,P 0. 05）,CFA IMT positively with hs- CRP,Fg（ r = 0. 367,0. 456,P 0. 05）,POA IMT positively with hs- CRP,Fg（ r = 0. 379,0. 417,P 0. 05）. Conclusion Lower extremity arterial IMT is positively correlated with hs- CRP,Fg in T2 DM patients. Dynamic monitoring of hs- CRP,Fg contributes to early prediction of the development of lower extremity arterial diseases,worthy of clinical application.