西安市细柳社区老年糖尿病患者颈动脉粥样硬化高危因素分析  

Risk factors analysis of carotid atherosclerosis in elderly diabetic patients of Xi'an Xiliu Community

作　　者：张景奇 吕涛[2] 

机构地区：[1]西安市长安区细柳中心卫生院,陕西西安710117 [2]西安交通大学医学院附属红会医院,陕西西安710054

出　　处：《国外医学（医学地理分册）》2013年第3期168-171,共4页Foreign Medical Sciences：Section of Medgeography

摘　　要：目的西安市细柳社区老年糖尿病患者颈动脉粥样硬化高危因素。方法选择在细柳中心卫生院进行健康检查的老年人3 482例中血糖升高患者567例,根据OGTT结果进行分组,对各组血脂水平、同型半胱氨酸(Hcy)、颈动脉内膜-中层厚度(IMT)等进行测定。结果三组之间BMI及收缩压、舒张压、年龄及性别构成无统计学差异(P>0.05)。IGT组患者TG较NGT组有显著增高(P<0.05),但TC、HDL、LDL并无显著统计学意义(P>0.05)。DM组患者TG、HDL、LDL较NGT组均有显著性差异(P<0.0S),但TC较NGT虽有升高但无统计学意义(P>0.05)。IGT组Hcy及IMT较NGT组有显著升高(P<0.05),HbA1c未见显著变化(P>0.05)。DM组患者Hcy、HbA1c及IMT较NGT、IGT组均有显著增高(P<0.05)。IMT与TG、HDL、HbA1c显著相关(P<0.05),与TC及LDL无显著相关性(P>0.05)。IMT与Hcy呈极显著正相关(P<0.01)。结论 Hcy升高是导致颈动脉粥样硬化的重要原因,其监测对判断糖尿病发生不同阶段颈动脉等大血管病变具有重要意义。Objective To evaluate the risk factors of carotid atherosclerosis in elderly diabetic patients of Xi- liu Community of Changan District of Xi＇an City. Methods A total of 567 cases with elevated blood sugar were chosen in 3482 senior citizens who had physical examination in our hospital. According to OGTT results,the 567 ca- ses were divided into normal glucose tolerance （NGT）group, impaired glucose tolerance （IGT）group, and diabetes mellitus （DM）group. The lipid levels, homocysteine （Hey）, and carotid intima-media thickness （IMT）were meas- ured. Results The BMI,systolic blood pressure,diastolic blood pressure,age and gender showed no significant sta- tistical difference （P〈0.05）. Compared with NGT patients, IGT patients had higher TG （P〈0.05）, but the TC, HDL and LDL showed no statistically significant difference （P〈 0.05）. TG, HDL and LDL of DM patients were significantly different from those of the NGT patients （P〈0.05）〈 compared with NGT patients, the TC were ele- vated but showed no significant difference （P〈 0.05）. Hcy and IMT of IGT patients were significantly higher than those of the NGT group （P〈0.05） ,but HbAlc showed no significant change （P〈0.05）. Compared with NGT and IGT groups,the Hcy,HbAlc and IMT of DM patients were significantly higher （P〈0.05）. IMT was greatly associ- ated with TG,HDL and HbAlc （P〈0.05）,but not with TC and LDL （P〈 0.05）. IMT and Hcy were positively correlated （P〈0.01）. Conclusions Elevated Hcy is a major cause for carotid atherosclerosis. Hcy monitoring can play a significant role in evaluating the different stages of diabetes and other major vascular lesions of carotid.

关 键 词：糖尿病 颈动脉粥样硬化 同型半胱氨酸 高危因素 

分 类 号：R743[医药卫生—神经病学与精神病学]