脂代谢紊乱对2型糖尿病患者并发症合并症的影响  

Influence of different kind of Dysiipidaemia on complication in type 2 diabetic patients

作　　者：谷成英[1] 王爱华[1] 曾艺鹏[1] 徐冬香[1] 

机构地区：[1]上海市南汇区中心医院内分泌科,上海201300

出　　处：《中国现代医学杂志》2009年第8期1253-1256,1259,共5页China Journal of Modern Medicine

摘　　要：目的比较不同脂代谢紊乱类型对2型糖尿病慢性并发症、合并症的影响。方法91例2型糖尿病患者,根据美国ATPIII标准将抽样对象分为血脂正常组及血脂紊乱组,后者又分为高三酰甘油组(TG组)、高胆固醇组(TC)、混合型高脂组3个亚组。用稳态模型评估法评估胰岛B细胞功能,常规检测血压、24h尿微量白蛋白、心电图、B超、肌电图,眼底进行并发症、合并症评估。结果91例2型糖尿病血脂紊乱发生率为54%,高三酰甘油组的空腹C肽及胰岛素明显高于正常组,其脂肪肝、冠心病、高血压的发病率明显高于正常组;TC组的脂蛋白a明显高于正常组,TC的异常增高与糖尿病神经病变、糖尿病性白内障关系密切;脂蛋白a与DN、DR密切相关。一般临床特征比较显示TG组和混合组的BMI明显高于正常组。结论2型糖尿患者脂代谢紊乱类型以高TG血症最常见,TG对冠心病、高血压等大血管病变作用更大,与脂肪肝关系密切;而TC、脂蛋白a与糖尿病肾病等微血管病变密切相关。[Objective] To evaluate the effect of different of Dysiipidaemia on complication in type 2 diabetic patients. [Methods] 91 type 2 diabetic patients were divided into normal and Dysiipidaemic groups according to AT- PIII standard. The Dysiipidaemic group included 3 subgroup as follows： high TG group with high triglycerides, high rig group with high cholesterol, mix group with both high triglycerides and high cholesterol Homeostasis model assessment was applied to estimate pancreatic islet B cell function. Examine blood pressure, trace of albumin all of 24 hours urine, ECG, type B ultrasound, EMG and eyegroud in order to evaluate the complication. [Results] Incidence of Dysiipidaemia among these type 2 diabetic patients is 54%. Fasting serum C peptide, FINS are increased and incidence of fatty liver, coronary heart disease ,high bood pressure is growing in the high TG group. Lp （a） is advancing in TC group, abnormal high TC and ly （a） were connected with the disturbance of nerve and cataract or DN and DR tighty. Common clinical character such as BMI was higher in high TG group than normal group. [Conclusion] High trglycerides was most common in type 2 diabetic paients, TG played the main role in fatty liver and principal blood vessels disease such as coronary heart disease ,high bood pressure. However, there was close relationship between TC, LP（a） and tiny blood vessel diseases such as DN.

关 键 词：2型糖尿病 脂代谢紊乱 糖尿病并发症 合并症 

分 类 号：R587.1[医药卫生—内分泌]