2型糖尿病动脉内中膜厚度的变化  

Alteration of artery intima-media thickness in patients with type 2 diabetes

作　　者：陈玲[1] 高平[1] 孙慧芳[2] 沈莹[1] 陆雷群[1] 郁忠勤[3] 王宇森[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院内分泌科,200020 [2]上海交通大学医学院附属瑞金医院卢湾分院超声科,200020 [3]上海交通大学医学院附属瑞金医院内分泌科

出　　处：《上海医学》2008年第9期617-619,共3页Shanghai Medical Journal

摘　　要：目的以动脉内中膜厚度(IMT)作为早期动脉硬化指标,观察2型糖尿病患者的IMT变化及其与代谢指标的相关性。方法收集2型糖尿病患者160例作为糖尿病组,其中糖化血红蛋白(HbA_1c)<7.0%作为控制良好亚组(37例),HbA_1c>7.0%作为控制不良亚组(123例)。另选择糖耐量正常的健康者作为正常对照组(38名)。采用高分辨彩色多普勒超声仪测定颈总动脉(CCA)、颈内动脉(ICA)和股动脉(FA)的IMT。结果糖尿病组的CCA-IMT、ICA-IMT、FA-IMT均显著厚于正常对照组(P值分别<0.05、0.01);且控制不良亚组均显著厚于控制良好亚组(P值均<0.05),经年龄校正后差异仍有统计学意义(P值均<0.05)。糖尿病组中,CCA-IMT、ICA-IMT及FA-IMT与年龄、总胆固醇、低密度脂蛋白胆固醇、HbA_1c均呈正相关(P值均<0.05)。结论2型糖尿病患者较糖耐量正常人群CCA、ICA、FA的IMT明显增厚,动脉硬化较严重,调控血糖、血脂有助于减轻IMT增厚,减少心脑血管并发症。Objective To observe the association between intima-media thickness （IMT） and the metabolic indices in patients with type 2 diabetes while taking the IMT as the indicator for early arthrosclerosis. Methods A total of 160 patients with type 2 diabetes were included in this study： 37 with HbA1c〈7.0% and were taken as excellent controlled group （group A）, 123 with HbA1c〉 7.0% and were taken as uncontrolled group （group ]3）. Another 38 normal subjects with normal glucose tolerance were taken as normal control. The common carotid artery intima-media thickness （CCA-IMT）, internal carotid artery intima-media thickness （ICA-IMT） ,and femoral artery intima-media thickness （FA-IMT） were measured in all the subjects with B mode colorful Doppler ultrasonography by the same doctor with the same instrument. Results CCA-IMT, ICA-IMT and FA-IMT in the 2 diabetic groups were significantly thicker than those of the normal control group （P〈0.05 or 0.01）, and those of group B were significantly thicker than those of group A （all P〈0.05） ; the significance still existed when the age was adjusted （all P〈0.05）. The measurements of CCA-IMT, ICA-IMT and FA-IMT in the diabetes groups were positively correlated with the age, total cholesterol （TCH）, low-density lipoprotein cholesterol （LDL-C）, and HbA1 c （all P〈 0.05）. Conclusion The measurements of CCA-IMT, ICA-IMT and FA-IMT in patients with type 2 diabetes are obviously thicker than those of the normal subjects, and the symptoms of arthrosclerosis are more severe. Control of blood glucose and lipid can reduce IMT and decrease the incidence of complications.

关 键 词：2型糖尿病 动脉内中膜厚度 动脉粥样硬化 颈总动脉 颈内动脉 股动脉 

分 类 号：R587.1[医药卫生—内分泌]