2型糖尿病患者臂踝脉搏波传导速度与颈动脉内膜中层厚度及斑块的关系

Relationship of brachial-ankle pulse wave velocity with carotid arterial intima-media thickness and carotid artery plaque in patients with type 2 diabetes mellitus

目的探讨2型糖尿病患者臂踝脉搏波传导速度(baPWV)与颈动脉内膜中层厚度(IMT)及颈部动脉斑块的关系,并分析引起动脉硬化的相关危险因素。方法收集426例2型糖尿病患者,进行baPWV、颈部动脉超声检查、生化指标检测及相关危险因素的记录。分析baPWV与IMT的相关性。并根据baPWV结果分为正常组与异常组,对两组的IMT、颈部动脉斑块及相关危险因素进行比较。结果两组危险因素中糖尿病病程、收缩压、舒张压、脉压、低密度脂蛋白胆固醇(LDL-C)、动脉硬化危险因素个数等比较差异有统计学意义(P<0.05,P<0.01);而年龄、腹围、BMI、尿酸、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、总胆固醇(TC)、糖化血红蛋白的比较差异无统计学意义(P>0.05)。两组颈部动脉超声斑块检出率差异无统计学意义(P>0.05),而两组斑块平均数量比较差异有统计学意义(P<0.01),异常组明显多于正常组;IMT正常率比较,差异有统计学意义(P<0.05),正常组明显高于异常组。两组IMT值比较,差异仍有统计学意义(P<0.01),异常组较正常组明显增厚。对baPWV与IMT进行相关性分析结果显示:IMT与baPWV呈正相关关系(r=0.228,P<0.05)。结论动脉弹性降低的2型糖尿病患者可能伴有颈IMT明显增厚、斑块数量明显增多。结合baPWV及颈部动脉超声检查可更好地进行颈动脉硬化的评估。

Objective To investigate the relationship between the brachial-ankle pulse wave velocity（baPWV）with the carotid arterial intima-media thickness（IMT）and carotid artery plaque in the patients with type 2diabetes mellitus（T2DM）and to analyze the related risk factors causing atherosclerosis.Methods A total of 426 patients with T2 DM were collected and conduct the records of baPWV,carotid artery ultrasound,biochemical index detection andrelated risk factors record.The correlation between baPWV with carotid arterial IMT was analyzed.The patients were divided into the abnormal group and normal group according to the baPWV results.The carotid artery IMT,carotid artery plaque and related risk factors were compared between the two groups.Results The DM duration,systolic blood pressure,diastolic blood pressure,pulse pressure,low density lipoprotein cholesterol（LDL-C）,number of atherosclerosis risk factors had statistically significant differences between the two groups（P〈0.05,P〈0.01）;while the age,waist circumference,BMI,uric acid,HDL-C,TG,TC,glycosylated hemoglobin had no statistically significant differences between the two groups（P〉0.05）.The detection rate of plaque by carotid artery ultrasound had no statistically significant difference between the two groups（P〉0.05）;but the statistically significant difference was found in the number of plaque between the two groups（P〈0.01）,the abnormal group was obviously more than the normal group;the normal IMT ratio had statistically significant difference between the two groups（P〈0.05）,the normal group was obviously higher than the abnormal group.The IMT value had statistical difference between the two groups（P〈0.01）,which in the abnormal group was significantly thickened compared with the normal group.The analysis of correlation between baPWV and IMT showed that IMT was positively correlated with baPWV（r=0.228,P〈0.05）.Conclusion T2 DM patients with reduced arterial elasticity could complicated with the obvious thickening of carotid arterial IMT and increase of plaque number.Combining baPWV with carotid arterial ultrasound examination can better conduct the arteriosclerosis evaluation.