老年2型糖尿病患者血糖波动与颈动脉病变的关系

The relationship between blood glucose fluctuation and carotid artery lesions in the elderly patients with type 2 diabetes

目的探讨研究老年2型糖尿病患者血糖波动与颈动脉内膜增厚、斑块形成的关系。方法选择89例老年2型糖尿病患者作为研究对象,按照颈动脉彩色多普勒超声显像结果将患者分为颈动脉正常组(46例)和颈动脉病变组(43例)。所有研究对象接受动态血糖监测系统(CGMS)连续72 h的血糖监测,分析两组患者的血糖水平、糖化血红蛋白(Hb Alc)、平均血糖浓度及一般生化指标的差异。结果颈动脉病变组的ln HOMA-IR、Hb Alc、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)高于颈动脉正常组(P<0.05);颈动脉病变组标准差(SD)、血糖波动最大幅度值(LAGE)、平均空腹血糖(MFBG)和变异系数(CV)值均显著高于颈动脉正常组(P<0.05);多元回归分析结果显示ln HOMA-IR、MPBG、LAGE与内膜中层厚度显著相关,回归系数分别为0.012、0.104、0.176(P均<0.05)。结论血糖波动是老年2型糖尿病患者发生颈动脉内膜增厚和斑块发生的危险因素。

Objective To investigate the relationship between blood glucose fluctuation and carotid intima media thickness,plaque formation in the elderly patients with type 2 diabetes mellitus.Method 89 cases of elderly patients with type 2 diabetes were collected and divided into the normal carotid artery group（46 cases）and carotid ar-tery disease group（43 cases）according to the results of carotid artery color Doppler ultrasonography.All subjects un-derwent continuous glucose monitoring system（CGMS）for 72 hours of continuous glucose monitoring,The blood glu-cose levels,glycosylated hemoglobin,mean blood glucose concentration and biochemical indexes were observed and compared between the two groups.Results The lnHOMA-IR,HbAl c,LDL-C and SBP in carotid artery disease group were higher than those in normal group,and the difference was statistically significant（P〈0.05）.The duration of ca-rotid artery disease in patients with diabetes group（11.8 ＆#177;2.36）was longer than that in the normal group（7.3 ＆#177; 1.46years）（P〈0.05）;the SD,LAGE,MPGE and CV levels in Carotid artery disease group were significantly higher than those in normal group,there were significant difference between the two groups（P〈0.05）;The results of multi-ple regression analysis showed IMT was significantly correlated with lnHOMA-IR,MPBGand LAGE,the regression co-efficients were 0.012,0.104 and 0.176 respectively（P〈0.05）.Conclusion The intimal thickening and plaque for-mation is related to blood glucose fluctuation in the elderly type 2 diabetic patients with carotid artery.