2型糖尿病患者颈动脉内膜中层厚度与血同型半胱氨酸水平的关系  

Relationship between carotid intima-media thickness and plasma homocysteine in type 2 diabetic patients

作　　者：韦晓强 张征[1] 沈若宇[1] 张炜[1] 徐尔理[1] 

机构地区：[1]解放军第四一一医院,上海200081

出　　处：《海军医学杂志》2015年第5期434-437,共4页Journal of Navy Medicine

摘　　要：目的评价2型糖尿病患者颈动脉内膜中层厚度(MT)与血同型半胱氨酸(Hcy)的关系。方法检测127例初发2型糖尿病患者相关指标(体质量指数、血压、血脂及血糖),同时检测患者血Hcy与颈动脉MT,将所得结果与103例对照组进行比较。所有2型糖尿病患者经治疗后随访测值再与治疗前比较。结果 (1)2型糖尿病组患者治疗前三酰甘油及血Hcy高于对照组。2型糖尿病组中Hcy升高者为32.3%(41/127),高于对照组的9.7%(10/103)。2型糖尿病组中,高Hcy者颈动脉MT[(0.98±0.20)mm]亦高于正常Hcy者[(0.88±0.16)mm]。(2)2型糖尿病患者经降糖、降压及调脂治疗后,颈动脉MT未见明显下降,高Hcy者颈动脉MT[(1.13±0.18)mm]仍高于正常Hcy者[(0.91±0.16)mm],多元逐步回归分析提示,2型糖尿病组血Hcy为影响颈动脉MT的独立相关因素。结论高同型半胱氨酸血症可能是2型糖尿病合并早期动脉粥样硬化的危险因素之一。Objective To evaluate the relationship between carotid intima-media thickness（ MT） and plasma homocysteine（ Hcy） in type 2 diabetic patients. Methods Related indexes,such as body mass,blood pressure,blood lipid and blood sugar were evaluated in 127 patients with type 2 diabetes. At the same time,plasma homocysteine and carotid intima-media thickness were also measured. The obtained results were compared with those of the 103 controlled cases. After treatment,all the data detected during medical follow-ups were compared with those before treatment. Results（ 1） Before treatment,the triglyceride and Hcy levels of the type 2diabetic patients were significantly higher than those of the control group. The elevated Hcy level in the patients with type 2 diabetes was32. 3%（ 41 /127）,which was obviously higher than 9. 7%（ 10 /103） of the control group. In the type 2 diabetic patients with high Hcy,MT was also higher than that of the patients with normal Hcy.（ 2） Following treatment,no significant reduction in carotid MT was seen in type 2 diabetic patients,and carotid MT in the patients with high Hcy was still higher than that of the patients with normal Hcy. Stepwise multiple regression analysis indicated that plasma Hcy concentration was a related independent factor influencing carotid MT of the type 2 diabetic patients. Conclusion Our study indicated that hyperhomosysteinemia might be one of the risk factors associated with early atherosclerosis in type 2 diabetic patients.

关 键 词：同型半胱氨酸 2型糖尿病 血管病变 

分 类 号：R587.1[医药卫生—内分泌]