多因素强化干预对2型糖尿病患者髂总动脉内中膜厚度的影响  

The Effects of Intensive Multifactorial Intervention on Intima-media Thickness of Iliac Artery in Type 2 Diabetic Patients

作　　者：那娜[1] 王奇金[1] 吴鸿[1] 黄勤[1] 丁长花[1] 邹大进[1] 

机构地区：[1]第二军医大学长海医院内分泌科,上海200433

出　　处：《福建医科大学学报》2011年第2期97-100,共4页Journal of Fujian Medical University

基　　金：国家科技部"十五"攻关课题(2004BA702B01)

摘　　要：目的评估2型糖尿病(T2DM)患者在通过强化控制血糖、血压、血脂等多种因素后,其髂总动脉内中膜厚度(IMT)及其影响因素的变化情况。方法对照研究强化控制100例资料完整的新诊断T2DM患者3年前后血糖、血压、血脂等生理指标及髂总动脉IMT的变化情况。先单因素分析,再通过多元线性逐步回归法分别分析干预前后髂总动脉IMT的影响因素。结果通过3年的强化干预,髂总动脉IMT治疗后为(0.72±0.18)mm,较治疗前的(0.80±0.15)mm明显降低(P<0.01);餐后2 h血糖(2hPG)、总胆固醇(TC)、甘油三酯(TG)较治疗前改善(P<0.05),空腹胰岛素(FINS)水平较治疗前显著升高(P<0.01)。多元线性回归分析提示,强化干预前收缩压(SBP)、空腹血糖(FPG)、TC为髂总动脉IMT的危险因素(P<0.05),干预后TC、体质量指数(BMI)、性别为髂总动脉IMT的影响因素(P<0.05)。结论新诊断T2DM患者的髂总动脉IMT可通过早期多因素强化干预而在一定程度上被逆转,其强化干预前后的影响因素分别为SBP、FPG、TC及TC、BMI、性别。Objective To assess the efficacy of intensive multifactorial intervention by examining the change of intima-media thickness（IMT） of iliac artery in newly diagnosed type 2 diabetic（T2DM）patients.Methods A total of 100 newly diagnosed T2DM patients were recruited in the study,all of them have received intensive control of blood glucose,blood pressure and blood lipid for 3 years.Compare the change of every physiological indicator and IMT of iliac artery.Then through single factor and multinomial regression analysis,analyze the effective factors on the change of IMT of iliac artery.Results Following 3 years intensive control,the level of IMT of iliac artery（0.72±0.18）mm was much lower than pretherapeutic level（0.80±0.15）mm（P〈0.01）.2 hour postprandial glucose（2hPG）,total cholesterol（TC） and triglycerides（TG） were improved obviously（P〈0.05）.The level of fasting plasma insulin（FINS） increased significantly,comparing with the stage of pretreatment（P〈0.05）.The pretherapeutic IMT of iliac artery was correlated with the systolic blood pressure（SBP）,fasting glucose（FPG） and TC（P〈0.05） by multinomial regression analysis,however,after the intensive intervention of life style and treatment,IMT of iliac artery was correlated with TC,Body mass index（BMI） and gender（P〈0.05）.Conclusion The IMT of iliac artery could be reversed to a certain extent by multifactorial intervention in newly diagnosed T2DM patients.The influential factors of IMT of iliac artery before intensive multifactorial intervention were SBP,TC,FPG,and after intervention they changed into TC、BMI and gender.

关 键 词：糖尿病 2型 髂动脉中膜厚度 危险因素 多元分析 回归分析 血脂异常 血糖 人体质量指数 

分 类 号：R587.105[医药卫生—内分泌] R543.502[医药卫生—内科学]