2型糖尿病并颈动脉斑块与超敏C反应蛋白及同型半胱氨酸的关系

Relationship between Type 2 Diabetes Mellitus Complicated with Carotid Plaque and High Sensitivity C-reactive Protein Homocysteine

目的:研究2型糖尿病并颈动脉斑块与超敏C反应蛋白(hs-CRP)及同型半胱氨酸(Hcy)的关系。方法:选择2014年1月-2015年6月笔者所在医院收治的90例2型糖尿病患者为研究对象,所有患者进行多普勒超声检查颈动脉,观察颈动脉内膜-中层厚度(IMT)及颈动脉有无斑块,并根据有无斑块情况分为有斑块组48例,无斑块组42例;对照组选取健康体检者50例。检测三组对象的血浆Hcy、血清hs-CRP及血脂水平,研究它们的相关性。结果:单因素分析显示,三组对象间的年龄、hs-CRP、Hcy检测水平及IMT测值按对照组→无斑块组→有斑块组的顺序递升(P<0.01)。多因素Logistic回归分析显示,hs-CRP(OR=2.817,P<0.01)、Hcy(OR=1.235,P<0.01)水平升高是2型糖尿病患者颈动脉粥样硬化形成的独立危险因素。结论:早期监测并干预hs-CRP及Hcy水平,可预防、延缓2型糖尿病患者动脉粥样斑块的发生。

Objective：To study the relationship between type 2 diabetes mellitus and carotid plaques with high sensitivity C-reactive protein（hs-CRP） and homocysteine（Hcy）.Method：From January 2014 to June 2015,in our hospital 90 cases with type 2 diabetes were selected as the research object,all patients underwent carotid artery color Doppler ultrasound examination of carotid intima-media thickness（IMT） and carotid artery plaques,and according to the plaques were divided into plaque group 48 cases,42 cases of non plaque group;randomly selected 50 healthy cases as control group.The plasma Hcy,serum hs-CRP and blood lipid levels of the 3 groups were detected,and the correlation was analyzed.Result：Univariate analysis showed that 3 groups of objects between age,hs-CRP,Hcy and IMT levels measured in control group and non plaque group,the order of ascending the plaque group（P〈0.01）.Multivariate Logistic regression analysis showed that elevated levels of hs-CRP（OR=2.817,P〈0.01） and Hcy（OR=1.235,P〈0.01） were independent risk factors for carotid atherosclerosis in patients with type 2 diabetes mellitus.Conclusion：Early monitoring and intervention of hs-CRP and Hcy levels can benefit in preventing and delaying the occurrence of atherosclerotic plaques in patients with type 2 diabetes mellitus.