2型糖尿病患者糖化血红蛋白与颈动脉斑块稳定性相关性的研究

Correlation between HbA_(1c) level and carotid plaque stability in type 2 diabetes mellitus patients

目的 探讨T2DM患者HbA_(1)c与颈动脉斑块稳定性的相关性。方法 选取2018年10月至2020年10月于华北理工大学附属医院内分泌科就诊且颈动脉超声检查斑块厚度>1.5 mm的T2DM患者100例,根据HbA_(1)c水平分为HbA_(1)c≤7%组(n=21)、7%<HbA_(1)c≤9%组(n=28)及HbA_(1)c>9%组(n=51)。结果 7%<HbA_(1)c≤9%、HbA_(1)c>9%组FPG高于HbA1_(c)≤7%组(P<0.01)。HbA_(l)c≤7%、7%<HbA_(l)c≤9%、HbA_(l)c>9%组斑块厚度依次升高(P<0.01),斑块整体、近心段、中部、远心段增强程度高级别比例依次升高(P<0.05或P<0.01)。Pearson相关分析显示,HbA_(1)c、FPG及2 hPG与斑块厚度、长度呈正相关(P<0.05)。Spearman相关分析显示,HbA_(1)c与斑块表面、极低回声、斑块整体、近心段、中部及远心段增强强度呈正相关(P<0.05)。结论 HbA_(1)c可评价T2DM患者血糖控制情况,与颈动脉斑块稳定性相关,HbA_(1)c越高,斑块稳定性越差。

Objective To explore the correlation between HbA_(1c) level and carotid plaque stability in type 2 diabetes mellitus(T2DM) patients.Methods From October 2018 to October 2020,100 T2DM patients who visited our hospital and underwent carotid artery ultrasound examination with a plaque thickness greater than 1.5 mm were included in this study.According to HbA_(1c) levels,they were divided into HbA_1c≤7% group(n=21),7%<HbA_1c≤9% group(n=28),and HbA_1c>9% group(n=51).Results The FPGs of the 7%<HbA_1c≤9% and HbA_1c>9% groups were higher than that of the HbA_1c≤7% group(P<0.01).The plaque thickness gradually increased from group HbA_1c≤7%,7%<HbA_1c≤9% to HbAlc>9% groups(P<0.01),and the proportion of high-level enhancement in the overall,proximal,middle,and distal segments of the plaque increased in sequence(P<0.05 or P<0.01).Pearson correlation analysis showed that HbA_1c,FPG,and 2 hPG were positively correlated with plaque thickness and length(P<0.05).Spearman correlation analysis showed that HbA_(1c) was positively correlated with the smoothness of the plaque surface,the presence of extremely low echogenicity within the plaque,and the overall,proximal,central,and distal enhancement intensity of the plaque(P<0.05).Conclusion HbA_(1c) can not only evaluate the blood glucose control of T2DM patients,but also has a certain correlation with the stability of carotid plaque,with a trend of poorer plaque stability as HbA_(1c) increases.