2型糖尿病代谢紊乱状况与颈动脉内膜中层厚度的关系  

The Relationship between Metabolic Disturbance and Carotid lntima-media Thickness in Type 2 Diabetes

作　　者：吴培红[1] 胡耀敏[1] 黄融[1] 张小英[1] 杨洁瑾[1] 成琦[1] 刘伟[1] 

机构地区：[1]上海交通大学医学院附属仁济医院内分泌科,上海200127

出　　处：《中国临床医学》2006年第6期965-967,共3页Chinese Journal of Clinical Medicine

摘　　要：目的：探讨2型糖尿病(T2DM)患者不同的血糖、血压和血脂控制状态与颈动脉内膜中层厚度(IMT)的关系。方法：回顾分析587例住院T2DM患者的IMT,将其分为IMT＜0．8mm和IMT≥0．8mm两组,比较两组的一般情况．血糖、血压和血脂等代谢指标,以及两组代谢控制良好者的比例；比较不同的代谢控制对颈动脉IMT的影响。结果：(1)与IMT＜0．8mm组相比,IMT≥0．8mm组的年龄明显增大(P=0．000)、病程较长(P=0．009)、有高血压史者的比例增多(P =0．017),体重指数(BMI)较大(P=0．040),收缩压(SBP)较高(P=0．003)。(2)根据血糖、血压和血脂控制是否良好分成4组,只有当3项指标均良好时,患者的IMT明显低于其他各组(P＜0．05)。结论：T2DM患者颈动脉IMT受血糖、血压和血脂水平的共同影响,严格控制各项代谢紊乱将延缓IMT的发展,减轻动脉粥样硬化。Objective：To study the the relationship between metabolic disturbance and carotid intima-media thickness （IMT） in T2DM. Methods Retrospective analysis has been adopted about 587 hospitalized type 2 diabetic patients, and those individuals who had complete data of carotid IMTs were subdivided into two groups, viz IMT〈0. 8 mm and IMT≥0.8 mm General da ta,SBP,DBP, HbAlc, TC, TG, LDL-C-c, HDL-C-c, and carotid IMTs were compared between two groups. The impact of hyperglycemia, hypertension and dyslipidemia on IMT had been calculated. Results： （1） Patients whose IMT≥0.8 mm tended to be elder and provided a longer history of diabetes , more patients had a hypertensive history and had a higher level in terms of body mass index（BMI） and systolic blood pressure comparing to those in group of IMT〈0.8 mm （P〈0. 05） . （2） Only those patients whose data of HbAlc, SBP, DBP, TG, TC, LDLc, HDLc totally met the targets set by the Type 2 Diabetes Policy Group, the IDF-WPR, had a less thickness in the carotid IMTs （P〈0.0）. Conclusion. Carotid IMT in type 2 diabetic patients is influenced by metabolic status, and tight control of glucose, blood pressure and lipid concentration will delay the pro gression of carotid IMT and the development of atherosclerosis.

关 键 词：颈动脉内膜中层厚度 高血压 高脂血症 动脉粥样硬化 2型糖尿痛 

分 类 号：R587.1[医药卫生—内分泌]