多种无创检测方法评价糖尿病患者早期动脉硬化  

Evaluation of early arteriosclerosis in patients with diabetes mellitus by several non-invasive methods

作　　者：胡艳丽[1] 李昭屏[1] 张会欣[3] 肖文华[2] 邱萌[1] 李蕾[1] 高炜[1] 

机构地区：[1]北京大学第三医院心内科、分子心血管学教育部重点实验室,100191 [2]北京大学第三医院内分泌科 [3]石家庄市第二医院功能科

出　　处：《中国心血管杂志》2010年第3期206-209,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的多种无创检测方法联合评价2型糖尿病（DM）患者早期动脉硬化情况。方法无并发症的DM患者30例，对照组27例，行颈动脉内膜中层厚度（IMT）、踝臂指数（ABI）、肱踝脉搏波传导速度（baPWV）、压力波增强指数（AI）及血管回声跟踪技术（ET技术）检查，比较两组动脉硬化参数及其相关性。结果DM组及对照组IMT、ABI均在正常范围，且差异无统计学意义（均为P〉0．05）；左右两侧baPWV[（1449±232）cm／s比（1291±171）cm／s，（1452±222）cm／s比（1280±178）cm／s；P〈0．01]及ET技术中压力-应变弹性系数（Ep）[（137±51）kPa比（101±34）kPa，P〈0．01]、硬化参数（β）[（10．6±4．2）比（8．2±2．7），P〈0．05]、单点脉搏波传导速度（PWVβ）[（7．0±1．2）m／s比（6．1±1．0）m／s，P〈0．01]在DM组均明显高于对照组。DM组动脉硬化的发生率较对照组升高[67％（20／30）比26％（7／27），P〈0．01]；Ep、PWVβ分别与左右两侧baPWV呈正相关。结论DM患者动脉硬化发生率较对照组明显增加；ET技术中Ep、β、PWVβ与baPWV均可敏感地反映糖尿病患者早期动脉硬化。Objective To evaluate early arteriosclerosis in patients with type 2 diabetes mellitus （T2DM） by several non-invasive methods. Methods A total of 30 T2DM patients without complications and 27 control people were enrolled. The parameters of arteriosclerosis,including carotid intima-media thickness （ [MT）, ankle brachial index （ABI） , brachial-ankle pulse wave velocity （baPWV） ,augmentation index （AI） and echo-tracking technique （ET） were compared between the two groups. Restdts IMT and ABI in two groups were within normal range and there were no statistical differences between two groups. Pressure-strain elastic modulus （Ep） [ （ 137 ±51 ） kPa vs. （ 101±34 ） kPa, P 〈 0. 01 ], stiffness parameter （β） [ （10. 6 ± 4. 2 ） vs. （8. 2 ± 2. 7）, P 〈 0. 05 ] and one-point pulse wave velocity（PWVβ） [ （7. 0 ± 1.2）m/svs. （6.1 ±1.0） m/s,P〈0.01] in ET and left baPWV[（1449±232） cm/s vs. （1291±171）cm/s,P〈 0.01 ] ,right baPWV [ （ 1452 ±222）cm/s vs. （ 1280 ± 178） cm/s,P 〈0.01 ]in T2DM group were significantly higher than those in control group. Incidence of arteriosclerosis in T2DM group was statistically higher [67% （20/30） vs. 26% （7/ 27） ,P 〈 0. 01 ]. Ep and PWVβ were positively correlated with baPWV. Conclusions Incidence of arteriosclerosis was higher in T2DM patients even without complications ;Ep,βand PWVβ in echo-tracking technique and baPWV appear to be sensitive methods for detection of early arteriosclerosis.

关 键 词：糖尿病 2型 动脉硬化 脉搏 反射波增强指数 

分 类 号：R587.1[医药卫生—内分泌] R543[医药卫生—内科学]