合并微量白蛋白尿的老年糖尿病患者颈动脉内膜中层厚度的变化分析

Alteration of carotid intima media thickness in elderly diabetes patients complicated with microalbuminuria

目的探讨伴有微量白蛋白尿(MAU)的老年2型糖尿病(T2DM)患者颈动脉内膜中层厚度(C-IMT)的变化情况。方法入选成飞医院心血管内科的老年T2DM患者180例,依据是否合并MAU分为两组:MAU组(n=60)和非MAU组(n=120)。检测并对比两组患者的临床资料及相关指标。结果与非MAU组相比,MAU组患者的甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(UA)、血肌酐(Scr)、斑块发生率、C-IMT、血管阻力指数(RI)和血管博动指数(PI)均显著增高,而肾小球滤过率、管腔内径、颈动脉收缩期峰值血流速度(PSV)和舒张末期血流速度(EDV)均显著降低,差异均具有统计学意义(P<0.05)。随着采用硬化斑块指数(CAS)分期的增高,患者MAU水平呈递增趋势(F=29.874,P<0.001)。多元线性回归分析结果表明,合并MAU老年T2DM患者的C-IMT与MAU呈正相关。结论伴有MAU的老年T2DM患者C-IMT与MAU密切相关,检测T2DM患者的MAU可以对其心脑血管病变进行早期诊断。

Objective To investigate the alteration of carotid artery intima media thickness （C-IMT） in the elderly patients with type 2 diabetes mellitus （T2DM） and trace albumin in the urine （microalbuminuria, MAU）.Methods A total of 180 elderly T2DM patients hospitalized in our department were recruited in this study.According to complication of MAU or not, they were divided into MAU group （n=60） and non-MAU group （n=120）.Their clinical data and related indices were detected and compared between the 2 groups.Results Compared with the non-MAU group, the MAU group had significantly higher triglycerides （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, uric acid （UA）, serum creatinine （Scr）, incidence of plaque, C-IMT, resistance index （RI） and pulsatility index （PI）, but obviously lower glomerular filtration rate （GFR）, lumen diameter, carotid peak systolic blood flow velocity （PSV） and end diastolic velocity （EDV） （all P〈0.05）.The level of MAU was increased with the increase of sclerotic plaque index （F=29.874, P〈0.001）.Multiple linear regression analysis indicated that C-IMT was positively correlated with the MAU level in the elderly T2DM patients complicated with MAU.Conclusion C-IMT and MAU are closely associated in the elderly T2DM patients complicated with MAU.Detection of MAU is of value in the early diagnosis of cardiovascular and cerebrovascular diseases in these patients.