2型糖尿病患者颈动脉斑块危险因素分析  

Risk factors for carotid plaques in patients with diabetes mellitus type 2

作　　者：高鑫 马琳 杨华[2] 

机构地区：[1]河北省唐山市开滦集团公司总医院超声科,063000 [2]河北联合大学附属医院超声科

出　　处：《中华全科医学》2015年第4期584-585,601,共3页Chinese Journal of General Practice

摘　　要：目的 分析2型糖尿病患者颈动脉斑块的相关危险因素。方法 选择2型糖尿病患者185例,应用高频超声（5-12 Hz）观察患者颈动脉,按是否发生斑块将患者分为斑块组与无斑块组,分析2型糖尿病患者颈动脉斑块与性别、年龄、病程、体质量指数（Body Mass Index）、血压、血脂的关系。结果 2型糖尿病患者的斑块检出率为70.3%（130/185）;斑块组年龄、病程、BMI、TC和SBP高于无斑块组,差异有统计学意义（P〈0.05）;多因素非条件Logistic回归分析结果 表明,病程≥5年[OR=2.512,95%CI（1.216-4.902）,P=0.010]和TC≥5.18 mmol/L[OR=1.668,95%CI（1.063-2.814）,P=0.029]是2型糖尿病患者颈动脉斑块的发生的独立危险因素。结论 2型糖尿病患者颈动脉斑块的发生是多因素共同作用的结果 ,病程长和高胆固醇是其独立危险因素,早期积极进行颈动脉超声检查和控制血脂代谢紊乱,有利于减少心脑血管并发症的发生。Objective To evaluate the relevant risk factors for carotid artery plaques in patients with diabetes mellitus type 2. Methods 185 patients with diabetes mellitus type 2 were enrolled and divided into plaque group and no plaque group according to ultrasound assessment of carotid artery. The relationship between the carotid artery plaques and gender, age, course of disease, body mass index （ BMI）, blood pressure and level of blood cholesterol were analyzed. Results The prevalence of plaque in the patients with diabetes mellitus type 2 was 70.3% （130/185）. Compared to the patients with- out plaque group, the patients with plaque group were older, they were commonly with longer course of disease, higher level of BMI and total cholesterol （ TC ）, and systolic blood pressure （SBP） （ P 〈 0.05 ）. Multi-factor logistic regression analysis showed the course of disease t〉 5 years [ OR = 2.512,95% CI（ 1.216 - 4. 902 ）, P = 0.010 ] and the level of TC≥ 5.18 mmol/L [ OR ： 1. 668,95% CI（ 1. 063 -2. 814） ,P =0. 029] were independent risk factors of carotid plaque in patients with diabetes mellitus type 2. Conclusion Longer course of disease and higher level of TC are the independent risk fac- tors of carotid plaque in patients with diabetes mellitus type 2. Check carotid artery with ultrasound and control blood lipid metabolic disorder earlier can be benefit for reducing cardiac and brain vascular complications.

关 键 词：糖尿病 2型 动脉粥样硬化 超声 危险因素 

分 类 号：R587.1[医药卫生—内分泌] R543.4[医药卫生—内科学]