糖尿病视网膜病变、纤维蛋白原及血细胞比容与2型糖尿病颈动脉狭窄的关系

Relationship of diabetic retinopathy,fibrinogen and hematocrit with carotid artery stenosis in type 2 diabetes mellitus

目的探讨糖尿病视网膜病变(DR)、纤维蛋白原(FIB)及血细胞比容(HCT)与2型糖尿病(T2DM)患者发生颈动脉狭窄的关系。方法收集2016年8月至2020年12月于青岛大学附属医院完成颈动脉超声检查并行眼底检查的175例T2DM患者的临床资料,根据颈动脉超声检查结果将其分为颈动脉狭窄组(n=86)和无狭窄组(n=89),分析T2DM患者发生颈动脉狭窄的影响因素。结果单因素分析结果显示,高血压病史、DR、FIB、HCT均为T2DM患者发生颈动脉狭窄的影响因素(P<0.05)。进一步将单因素分析中P<0.1的影响因素,包括年龄、高血压病史、DR、高密度脂蛋白胆固醇(HDL-C)、FIB及HCT纳入Logistic回归模型中进行多因素分析,结果显示,DR、HDL-C、FIB均是T2DM患者发生颈动脉狭窄的影响因素(P<0.05)。狭窄组轻度、中度、重度狭窄或闭塞患者的FIB水平比较,差异均无统计学意义(P>0.05)。Kendall's tau-b相关系数分析显示,DR分期与狭窄程度不存在相关性(r=-0.023,P=0.816)。结论DR、FIB、HCT、HDL-C、高血压病史均是T2DM患者发生颈动脉狭窄的影响因素,其中DR、FIB是T2DM患者发生颈动脉狭窄的独立影响因素。

Objective To investigate the relationship of diabetic retinopathy(DR),fibrinogen(FIB)and hematocrit(HCT)with carotid artery stenosis in patients with type 2 diabetes mellitus(T2DM).Method Clinical data of 175 patients with T2DM in the Affiliated Hospital of Qingdao University from August 2016 to December 2020 were collected,and divided into stenosis group(n=86)and non-stenosis group(n=89)to analyze the influencing factors of carotid artery stenosis in T2DM patients.Result Univariate analysis showed that age,history of hypertension,DR,FIB and HCT were influencing factors of carotid artery stenosis in T2DM patients(P<0.5).The influencing factors of P<0.1 in the single factor analysis were further analyzed,showed DR,high density lipoprotein cholesterol(HDL-C)and FIB were influencing factors of carotid artery stenosis in T2DM patients(P<0.05).There were no significant differences in FIB levels among patients with mild,moderate,severe stenosis or occlusion in the stenosis group(P>0.05).Kendall's tau-b correlation coefficient analysis showed there was no correlation between DR stage and severity of stenosis(r=-0.023,P=0.816).Conclusion DR,FIB,HCT,HDL-C and history of hypertension are influencing factors for carotid artery stenosis in patients with T2DM,DR and FIB are independent influencing factors for carotid artery stenosis in patients with T2DM.