2型糖尿病患者颈动脉内膜中层厚度的观察  

The intimal-medial wall thickness of common carotid artery in type 2 DM

作　　者：卢纹凯[1] 苗小平[2] 韩东升 张颖[2] 毛腾淑[1] 

机构地区：[1]北京医科大学人民医院内分泌科,邮政编码100044 [2]北京医科大学人民医院超声影像科,邮政编码100044

出　　处：《中国糖尿病杂志》2000年第5期275-278,共4页Chinese Journal of Diabetes

摘　　要：目的　探讨 2型糖尿病 (DM)患者颈动脉内膜中层厚度 (IMT)改变及与各种危险因子的关系。方法　对 5个年龄组 12 3例 DM患者和 10 2例正常人行超声波 IMT检测 ,并对界值上下两组 DM患者临床数据进行比较。结果　 1DM患者与正常人 IMT均随年龄增长而增厚 ,各年龄组 DM患者 IMT均较正常人明显增厚 (P<0 .0 5～ P<0 .0 1) ,30岁～、40岁～组 DM病人与 5 0岁～、6 0岁～组正常人 IMT相似。 2正常人 IMT为 0 .6 1± 0 .0 7mm,其中 98%为 <0 .8mm;DM患者 IMT为 0 .85± 0 .2 1mm,其中 5 6 %为≥ 0 .8mm。 3DM患者 IMT≥ 0 .8mm组的收缩压、舒张压、高血压病程、空腹胰岛素、2 4小时尿白蛋白、CHD及 CVD发生率明显增高 ,胰岛素敏感指数却明显低于 IMT<0 .8mm组 (P<0 .0 5～ P<0 .0 1) ,而空腹血糖、餐后 2小时血糖、2小时胰岛素、Hb A1c、胆固醇、甘油三酯两组间无显著性差异。结论　DM患者 IMT增厚早、进展快 ,IMT≥ 0 .8mm的 DM患者心脑血管病危险增加。尿白蛋白增加是 IMT增厚的标志。高血压、高胰岛素血症、胰岛素抵抗对动脉粥样硬化的促进作用从早期即存在影像学的证据。Objective In order to ascertain the change of IMT in patients with type 2 DM and the relationship between IMT and various risk factors.Methods Using B-mode ultrasonography to measure the IMT in 123 diabetics and 102 healthy controls and to compare the clinical data between two DM groupes.Results ① The IMT of both diabetics and controls increased with the age.The IMT of every age group was obviously thicker in diabetics than in controls ( P <0 05～ P <0.01).The IMT of diabetics at the age of 30～ and 40～ was the same as that of 50～ and 60～.②The IMT of controls was 0.61±0.07mm,98% of them was <0.8mm.The IMT of diabetics was 0.85±0.41mm,56% of them was ≥0.8mm.③SBP、DBP、the duration of hypertension,FIns,24h UALB,the percentage of CHD and CVD were apparently higher;ISI was obviously lower in group of IMT≥0.8mm than in group of IMT<0.8mm( P <0 05～ P <0.01).There was no significant difference in the duration of DM,the FBG,2hBG、HbA1c,2hIns,TC and TG between two groups.Conclusion The increase of IMT in type 2 DM develops early and rapidly.The increase of UALB is the marker of the thickened IMT.The chance of CHD and CVD in patients with IMT≥0.8mm is increased.It can be seen that hypertention,hyperinsulinimia and insulin resistance accelarate the AS since carly phase.

关 键 词：颈动脉 动脉粥样硬化 内膜中层厚度 Ⅱ型糖尿病 

分 类 号：R587.102[医药卫生—内分泌]