Detection of carotid artery fluid dynamics and serum inflammatory factors in patients with type 2 diabetes mellitus

Objective:To explore the value of fluid dynamic parameters and inflammatory factors in the prediction of early atherosclerosis in type 2 diabetes mellitus.Methods:A total of 126 patients with type 2 diabetes mellitus who were admitted to our hospital from March 2015 to July 2016 were selected as study subjects and divided into non atherosclerotic group (61 cases) and atherosclerosis group (65 cases)according to carotid artery IMT. At the same time, 60 healthy persons were selected as the control group. The fluid dynamics indexes (PSV, EDV and MV) and serum inflammatory factors (MCP-1, TNF-α and hs-CRP) were detected in the three groups.Results: There were no significant differences in PSV, EDV and MV between left and right carotid arteries in non-atherosclerotic group and control group. PSV, EDV and MV of left and right carotid artery were significantly lower in atherosclerosis group than those in control group. The carotid artery PSV, EDV and MV of left and right in atherosclerosis group were also significantly lower than those of non-atherosclerosis group. The MCP-1, TNF-α and hs-CRP levels in the non-atherosclerosis group were respectively (417.10±78.54), (85.72±9.97) and (3.73±0.61), significantly higher than those in the control group. The MCP-1, TNF-αand hs-CRP levels in atherosclerosis group were respectively (532.95±97.48), (123.56±12.85) and (5.39±0.74) , significantly higher than those in the control group and non-atherosclerosis group.Conclusion:Hydrodynamic parameters and serum inflammatory factors can be used as diagnostic criteria for carotid atherosclerosis in type 2 diabetic patients, and provide guidance for the early diagnosis of carotid atherosclerosis in patients with type 2 diabetes mellitus.

中老年人群颈动脉内中膜厚度分布特征及相关因素分析

目的：探讨中老年人群颈动脉内中膜厚度分布特征的现状及其相关因素。方法：于2012—10至2012—11，对中美心血管病和心肺疾病流行病学合作研究中的石景山人群复查心血管病危险因素并进行颈动脉超声检查，以此横断面数据进行分析。结果：共计调查1345人。其中1277人数据完整者纳入分析，年龄52。88岁。颈动脉内中膜厚度平均值为（0．68±0．10）mm，两性均随年龄而增加，趋势分析具有统计学意义（P〈0．001）。各年龄阶段颈动脉内中膜平均厚度男性均大于女性（P〈0．01）。多因素分析结果显示：男女两性颈动脉内中膜厚度随着年龄、收缩压、血糖、甘油三酯和体质指数的增加而增加（P〈0．05）。结论：除年龄和性别外，血压、血糖、血脂和肥胖与中老年人群颈动脉内中膜厚度密切相关，应作为心血管病防治的重点。

急性脑梗死患者血清补体C1q/肿瘤坏死因子相关蛋白3和白细胞介素6水平与颈总动脉内膜中层厚度的关系

目的探讨急性脑梗死患者血清补体C1q/肿瘤坏死因子相关蛋白3(CTRP3)、白细胞介素6(IL-6)水平与颈总动脉内膜中层厚度(IMT)的关系。方法选取2017年1月至2019年6月中山大学孙逸仙纪念医院收治的200例急性脑梗死患者为观察组,另选取同期于本院门诊体检的200例健康志愿者为对照组,比较2组血清CTRP3和IL-6水平、颈总动脉IMT和内径。根据美国国立卫生研究院卒中量表评分将观察组分为轻度损伤组(62例)、中度损伤组(92例)、重度损伤组(46例)。根据IMT值将急性脑梗死患者分为正常组(24例)、增厚组(73例)、斑块形成组(103例)。比较神经缺损程度、动脉硬化程度不同患者血清CTRP3和IL-6水平。采用Pearson双变量相关性分析方法分析血清CTRP3、IL-6水平与颈总动脉IMT之间的关系。结果观察组患者血清CTRP3水平、颈总动脉内径低于/小于对照组[(87±14)μg/L比(137±36)μg/L、(4.0±0.4)mm比(5.7±0.6)mm],血清IL-6水平、颈总动脉IMT高于/大于对照组[(116±30)ng/L比(23±7)ng/L、(1.39±0.55)mm比(0.89±0.26)mm],差异均有统计学意义(均P<0.05)。中、重度损伤组血清CTRP3水平、颈总动脉内径低于/小于轻度损伤组,且重度损伤组低于/小于中度损伤组,差异均有统计学意义(均P<0.05);中、重度损伤组血清IL-6水平、颈总动脉IMT高于/大于轻度损伤组,且重度损伤组高于/大于中度损伤组,差异均有统计学意义(均P<0.05)。增厚组、斑块形成组血清CTRP3水平低于正常组,且斑块形成组低于增厚组,差异均有统计学意义(均P<0.05);增厚组、斑块形成组血清IL-6水平高于正常组,且斑块形成组高于增厚组,差异均有统计学意义(均P<0.05)。Pearson相关性分析结果显示,急性脑梗死患者血清CTRP3水平与颈总动脉IMT呈负相关(r=-0.565,P=0.012),血清IL-6水平与颈总动脉IMT呈正相关(r=0.671,P=0.009),血清CTRP3水平与IL-6水平呈负相关(r=-0.463,P=0.017)。结论急性脑梗死患者血清CTRP3水平降低,IL-6水平升高,血清CTRP3、IL-6水平均与颈总动脉IMT密切相关,可能通过影响颈总动脉IMT参与急性脑梗死的发生进展。

脑梗死患者颈动脉内—中膜厚度与其预后的相关性研究

目的:探讨脑梗死患者颈动脉内-中膜厚度与其预后的影响因素。方法:收治脑梗死患者112例,根据颈动脉内-中膜厚度分成3组,其中正常组50例,增厚组38例,斑块组24例,对所有患者于治疗前后进行评分比较。结果:各组治疗前后评分比较差异有显著性(P<0.05),男女性别之间比较差异有显著性(P<0.05)。结论:脑梗死患者颈动脉内-中膜厚度的变化影响着患者的预后,厚度越大,预后越差。

2型糖尿病病人大动脉僵硬度相关危险因素研究

目的探讨分析2型糖尿病病人大动脉僵硬度及其相关危险因素。方法选取北京大学首钢医院2013年9月至2016年9月间收治的582例2型糖尿病病人作为观察组研究对象,同时选取来医院进行常规体检的384名正常人群为对照组,对两组研究对象行一般资料收集、颈动脉超声和脉搏波传导速度检查,观察比较两组检查结果。结果观察组病人收缩压、三酰甘油(triglyceride,TG)、体质量指数(body mass index,BMI)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、胰岛素抵抗指数、C反应蛋白(C reactive protein,CRP)、同型半胱氨酸都高于对照组,高密度脂蛋白胆固醇(high density lipoproteincholesterol,HDL-C)低于对照组,两组差异有统计学意义(P<0.05)。观察组病人颈动脉内中膜厚度(intima-media thickness,IMT)、颈-股动脉脉搏波传导速度(carotid-femoral pulse wave velocity,CF-PWV)高于对照组(P<0.05),其中观察组单侧斑块检出率为47.59%,对照组为14.22%,观察组双侧颈动脉斑块检出率为33.85%,对照组为5.47%,单、双侧观察组均高于对照组,两组差异有统计学意义(P<0.05)。对2型糖尿病病人脉搏波传导速度进行Logistic回归分析得知,年龄、收缩压、LDL-C、胰岛素抵抗指数、CRP是影响大动脉僵硬度的主要因素。结论 2型糖尿病病人中高血压、高脂血症的发生率明显高于正常人群,颈动脉更易生长斑块,且大动脉弹性明显减退,影响其僵硬度的因素有年龄、收缩压、LDL-C、胰岛素抵抗指数、CRP等。应在治疗中严格控制多重危险因素,提高治疗效果,改善病人生活质量。

视网膜动脉硬化与颈动脉内膜中层厚度相关性的分析

随着我国人民生活水平的提高和饮食习惯的改变,动脉硬化呈增高趋势,其特点是受累病变的内膜开始,眼部多表现为视网膜动脉硬化。本文对视网膜动脉硬化与IMT相关性及相关因素进行观察分析。结果表明,越来越多的视网膜动脉粥样硬化合并颈动脉内膜增厚,糖尿病患者IMT与视网膜动脉硬化是相互影响,互为因果的关系。颈动脉狭窄特别是颈内动脉狭窄可直接影响视网膜血供。因此,早期诊断有助于判定全身动脉硬化情况,对冠心病、高血压、脑血管意外以及CRAO等患者及高危人群起到良好的警示作用,延缓疾病的进展。

Effects of linagliptin on inflammatory factors and arteriosclerosis in patients with newly diagnosed type 2 diabetes mellitus

In the present study,we aimed to investigate the effects of linagliptin on inflammatory factors and carotid intima-media thickness(CIMT)in newly diagnosed type 2 diabetes mellitus(T2 DM)patients with carotid atherosclerotic disease(CAD).A total of 326 patients with newly diagnosed T2 DM complicated with CAD were randomly divided into two groups.There were 163 patients in the control group,who were treated with metformin monotherapy.There were 163 patients in the experimental group,who were treated with metformin in combination with linagliptin.The CIMT before and after treatment was measured by color Doppler ultrasound,and the contents of IL-6 and IL-1βbefore and after treatment were detected by ELISA.The levels of inflammatory factors and CIMT before and after treatment were compared between the two groups,and the correlation between IL-6,IL-1βand CIMT was studied.After 24 weeks of treatment,the levels of inflammatory factors and CIMT in the experimental group were significantly lower compared with the control group(P<0.01),and the serum levels of IL-6 and IL-1βwere positively correlated with CIMT.In the present study,we concluded that linagliptin could improve the levels of inflammatory factors and CIMT in newly diagnosed T2 DM patients with CAD,and IL-6 and IL-1βmight participate in the occurrence and development of CAD by influencing CIMT.

急性脑梗死患者血清CTRP3,CTRP9水平与颈总动脉内膜中层厚度的相关性分析

目的探讨急性脑梗死(Acute cerebral infarction, ACI)患者血清中补体C1q/肿瘤坏死因子相关蛋白3/9(Complement-C1q/tumor necrosis factor-related protein 3/9,CTRP3/9)的水平变化及其与颈总动脉内膜中层厚度(Carotid intima-media thickness, CIMT)的相关性。方法选取2015年12月-2019年1月本院收治的102例ACI患者进行研究(ACI组),并选取同时间段内98例体检健康者进行对照分析研究(对照组);分析比较2组受试者一般资料;采用酶联免疫吸附法(Enzyme linked immunosorbent assay, ELISA)检测2组受试者血清CTRP3,CTRP9水平;利用彩色多普勒超声仪检测2组受试者CIMT;Pearson法分析ACI患者血清CTRP3,CTRP9水平与CIMT以及CTRP3与CTRP9水平的关系;采用Logistic回归分析法ACI患者CIMT的影响因素。结果 ACI组血清低密度脂蛋白-胆固醇(Low density lipoprotein cholesterol, LDL-C)、总胆固醇(Total cholesterol, TC)、甘油三酯(Triglyceride, TG)水平均高于对照组(P<0.05),血清CTRP3,CTRP9、高密度脂蛋白-胆固醇(HDL-C)水平明显均明显低于对照组(P<0.05),CIMT较对照组增加(P<0.05);ACI患者血清CTRP3与CTRP9水平呈正相关(r=0.490,P<0.05),血清CTRP3,CTRP9水平与CIMT均呈负相关(r=-0.461、-0.482,P<0.05);TG,TC,LDL-C水平为ACI患者CIMT增加的危险因素(P<0.05),HDL-C,CTRP3,CTRP9水平为ACI患者CIMT增加的保护因素(P<0.05)。结论 ACI患者血清CTRP3,CTRP9水平均明显降低,两者可能与CIMT相互影响,共同影响ACI发生发展。