2型糖尿病患者颈动脉粥样硬化超声标识的相关性研究

CORRELATION OF ULTRASOND INDEX AND RISK FACTORS FOR CAROTIDATHEROSCLEROSIS IN TYPE 2 DIABETES MLLITUS

目的 :探讨 2型糖尿病患者颈动脉粥样硬化超声标识和动脉粥样硬化危险因素的相关关系。方法 :前瞻性随机调查对象 2 3 2例 ,年龄 64 .5± 9.1岁 ,分为 :糖尿病合并高血压组 (DM -EH) 60例 ;糖尿病组 (DM ) 3 1例 ;高血压病组 (EH) 85例 ;同龄正常人组 5 6例 ,应用高分辨彩色多普勒B型超声检测颈动脉及临床检查 ,经spss 10软件统计分析处理。结果 :颈动脉内 -中膜厚度 (IMT) :DM -EH组 (1.72± 0 .62mm) ,DM组 (1.48±0 .60mm)、EH组 (1.5 3± 0 .5 1mm)较对照组 (1.0 6± 0 .2 6mm)显著增厚 (P均 <0 .0 1) ;DM -EH组较DM组及EH组差异显著 (P均 <0 .0 5 )。颈总动脉 (CCA)内径 :DM -EH组 (7.0 0± 0 .68mm)较DM组 (6.60± 0 .5 3mm)显著增宽 (P <0 .0 5 ) ;EH组 (7.13± 0 .80 )较DM组增宽非常显著 (P均 <0 .0 1)。IMT与CCA半径比值(IMT/r) :三组较对照组增大均非常显著 (P均 <0 .0 1) ;DM -EH组EH组显著增大 (P <0 .0 1) ;孤立斑块发生率 :DM -EH组较 ;三组增高非常显著 (P均 <0 .0 1)。最大剪切率 (SR) :DM -EH组较另三组显著降低 (P均 <0 .0 5 )。多元逐步回归表明 1MT与年龄、舒张压、空腹血糖及LDL -c、CCA内径、舒张末峰速度 (VD)正相关。结论 :颈动脉粥样硬化指标 1MT和斑块增厚是DM合并大血管病?

Objective: To explore the correlation of ultrasond index and risk factors for carotid atherosclerosis in 2 type DM.Methods: The carotid arteries were examined by color dopple flow imaging in 232 subjects who were divided into the following groups: DM with hypertension (DM-EH ) group (n=60, 66.1±9.0 year old); DM group (n=31; 62.9±8.4 years old ) ; hypertension (EH)group (n=85,64.5±10.7year old ); normal controls ( n=56, 63.7±6.5year old ).Results:The carotid internal-media thickness(IMT) were significantly increased in all of the disease groups than controls (P all<0.01). It was thicker in the groupof DM-EH ( 1.72±0.62mm ) than that in the group of DM ( 1.48±0.60mm ) and also in the group of EH ( 1.53±0.51mm ) ( P < 0.05 ).The diameter of common carotid arteries(CCA) were significantly increased in the group of DM- EH (7.00±0.68mm ) than those in the group of DM ( 6.6±0.53mm ) (P<0.05), also in the group of EH ( 7.13±0.80mm ) than those in group of DM (P< 0.01 ) The rate of IMT and radius of CCA was significantly increased in all of the diseased group than those in controls (P all < 0.01 ) ,also in the group of DM- EH than those in the group of EH (P < 0.01 ) The incidence of rate of atherosclerous plague (ALP) of carotid artery was higher in group of DM- EH than those other groups ( P all < 0.01 ) Multiple regression stepwise analysis revealed that IMT was positive correlated with concentration of low-density lipoprotem cholesterol (LDL- c)and blood pressure, age, end-diastolic peak velocity(VD) and diameter of CCA. Conclusions: The results suggest thatdislipidemia, hypertension, hyperglycemia together with a clustering of risk factors for macrovascular complication in type 2 diabetes, may cause IMT creased.