摘要
目的运用超声测定糖尿病(DM)患者颈动脉内-中膜厚度(IMT)、内-中膜横切面积(IMCSA),探讨DM患者颈动脉粥样硬化与冠脉粥样硬化的关系。方法 151例DM患者行冠状动脉造影后根据病变情况分为DM合并冠心病(CHD)组(92例)和单纯DM组(59例),再根据病变情况将DM合并CHD组分为DM合并单支病变组(20例)、DM合并双支病变组(39例)及DM合并多支病变组(33例)。超声测得所有患者双侧颈总动脉平均IMT,IMCSA。DM合并CHD组根据糖化血红蛋白(Hb A1C)水平,分为A组和B组,并比较两组的各项指标。结果 DM合并冠脉双支、多支病变组患者颈总动脉IMT高于单纯DM组,差异均有统计学意义(P<0.05),冠脉单支、双支、多支病变组患者颈总动脉IMCSA大于单纯DM组,差异均有统计学意义(P值分别为P<0.05,P<0.01,P<0.01)。随着冠脉病变支数的增加,双侧颈总动脉斑块发生率亦增加(P<0.05)。B组Fg(4.28±1.15)g/L,UA(319.9±96.7)μmol/L,Hs-CRP(3.27±0.61)明显高于A组(3.75±1.14)g/L,(281.3±77.4)μmol/L,(2.98±0.76),差异均具有统计学意义(P<0.05);B组中发生多支、双支、单支狭窄者分别为23例(46.0%)、15例(30.0%)、12例(24.0%),A组发生多支狭窄者仅8例(19.0%),双支狭窄者11例(26.2%),单支狭窄者23例(54.80%),B组发生冠脉狭窄程度明显高于A组,差异具有统计学意义(P<0.05)。B组患者颈动脉超声显示IMT增厚者43例(86.0%),而A组显示IMT增厚者19例(45.2%),差异具有统计学意义(P<0.05)。结论颈总动脉斑块检出结合颈总动脉平均IMT及IMCSA增加提示DM患者可能存在冠脉粥样硬化,有助于决定是否进行冠脉造影检查明确诊断;Hb A1C水平的高低与心血管危险因素密切相关,应严格控制其Hb A1C水平。
Objective To explore the relationship between crotid atherosclerosis and coronary artery athcroselerosis by carotid uhrasnund detecting intima-media thickness anti ernss-seetional area to diabetes mellitus （ DM ）. Methods According to the rcsuhs of corohary angiography,151 patients with type 2 diabetes mellitus were divided into DM combined with corona heart disease（CHI）） group（ n = 92 and simple DM group（ n = 59 ） , and former group st, bdivided, based on the number of involved coronary arteries, into group 1 -vessel （ n = 20 ,group 2-vessel（ n = 39） ,grnop muhi-vessel artery（ n = 33）. Bilateral common carotid artery IMT, IMCSA were measured by uhrasound and analyzed in all cases. According to the level of HbAI C,the group of DM with CtlD were divided into two grotlps：group A（ t lhAIC 〈 6. 5% ,42 cases） and B（ HbA1C 〉6.5% ,50 cases）. Results IMT of common carotid artet7 in patients with 2- and muhi-vessel CAD showed higher than/hose in single DM subjects（ P 〈0.05）.
出处
《潍坊医学院学报》
2017年第1期30-32,共3页
Acta Academiae Medicinae Weifang
