2型糖尿病患者颈动脉内中膜厚度和硬化度  

Study on carotid intima-media thickness and stiffness in type 2 diabetic patients

作　　者：刘燕萍[1] 詹维伟[1] 林艳艳[1] 朱樱[1] 任新平[1] 张翼飞[2] 陈宇红[2] 李小英[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院超声诊断科,200025 [2]上海交通大学医学院附属瑞金医院内分泌科,上海市内分泌代谢病临床医学中心,上海市内分泌代谢病研究所

出　　处：《中华内分泌代谢杂志》2008年第4期391-393,共3页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的分析2型糖尿病患者不同血糖控制水平和患病时间对颈总动脉内中膜厚度（carotidin tima-mediathickness，CIMT）和颈总动脉硬化度（quantitative carotid stiffness，Qcs）的影响。方法将274例2型糖尿病患者根据病程和HbA1c水平进行分组，60例病程≤2年的2型糖尿病患者为初发组，另外214例病程〉15年的2型糖尿病患者根据HbA1c〈6．5％分为HbA1C正常组（96例），HbA1c〉16．5％分为HbA1c升高组（118例）。同时收集这些患者的临床资料，包括年龄、性别、身高、体重、血压、吸烟情况、体重指数、HbA1c以及空腹血脂等生化指标。用高分辨率彩色血管多普勒超声仪测量受试者的QCS和CIMT。结果（1）CIMT值在HbA1c正常组和升高组均显著高于初发组（P〈0．05或P〈0．01），而前二组之间差异并无统计学意义。QCS值在HbA1c升高组显著高于HbA1c正常组和初发组，而HbA1c正常组和初发组之间差异并无统计学意义；（2）相关性分析显示总胆固醇、收缩压、病程和CIMT之间存在显著正相关（P〈0．05或P〈0．01）；收缩压、年龄、病程、吸烟、HbA1c和QCS之间存在显著正相关（P〈0．05或P〈0．01）。结论CIMT适用于糖尿病患者的长期随访，而QCS反映血糖水平对颈动脉的影响较CIMT敏感。Objective To study the effect of blood glucose level and duration of type 2 diabetes mellitus on carotid intima-media thickness （CIMT） and quantitative carotid stiffness （QCS） in the patients with type 2 diabetes mellitus. Methods Two hundred and seventy-four type 2 diabetic patients （ diagnosed according to the World Health Organization criteria ） were involved in this study. The subjects were divided into three groups according to the HbA1clevels and duration of diabetes mellitus： 60 with duration ≤2 years （as newly diagnosed） , 96 with duration I〉5 years and HbA1c 〈6.5% , and 118 with duration ≥5 years and HbA1c ≥6.5%. CIMT and QCS of the common carotid artery were assessed by the high-resolution B-mode ultrasound unit and an echo-tracking system integrated in an ultrasound unit respectively. Results （ 1 ） In categorical analyses, the mean level of CIMT was increased from 720 p,m in subjects with a duration of diabetes mellitus ≤2 years to 770 μm in subjects with a duration of diabetes mellitus 〉 2 years and plasma HbA1c 〈 6.5% （P 〈 0.05 ） , and to 800 μm in subjects with a duration of diabetes mellitus 〉5 years and plasma HbA1c ≥6.5% （P 〈 0.01 ）. The corresponding values for QCS values were 4.5, 4.5 and 5.1 （P 〈 0.05 ）, respectively. （2） In multiple stepwise regression analyses, CIMT was significantly associated with the duration of diabetes mellitus, systolic blood pressure and serum concentration of total cholesterol, whereas QCS was significantly associated with age, duration of diabetes mellitus, smoking, HbA1c, systolic blood pressure （ P 〈 0.05 or P 〈 0.01 ）. Condusion QCS is suitable in evaluating the impact of blood glucose on carotid artery, while CIMT is an appropriate tool for long-term follow-up of diabetic patients.

关 键 词：硬化度 颈动脉内中膜厚度 糖尿病 2型 

分 类 号：R587.1[医药卫生—内分泌]