2型糖尿病患者冠脉病变与下肢动脉和颈动脉病变的关系  

Relationship between Coronary Artery Disease and Lower Extremity Artery and Carotid Artery Disease in Patients with Type 2 Diabetes Mellitus

作　　者：张磊[1] 包明晶[1] 吴冀川[1] 李蓬秋[1] 张学军[1] 

机构地区：[1]四川省人民医院内分泌科,四川成都610072

出　　处：《四川医学》2016年第10期1106-1109,共4页Sichuan Medical Journal

摘　　要：目的探讨2型糖尿病患者颈动脉和下肢动脉粥样硬化与冠状动脉病变的关系。方法收集2型糖尿病患者204例,所有患者进行颈动脉和下肢动脉多普勒超声检查以及冠状动脉双源CT检查,根据冠状动脉有无斑块形成分为冠脉病变组和非冠脉病变组,采集年龄、性别、血压、吸烟史等临床资料和糖化血红蛋白(Hb A1c)、血脂等实验室检查结果,分析冠状动脉病变的危险因素及与外周动脉粥样硬化的关系。结果 204例2型糖尿病患者中,冠状动脉病变143例,非冠脉病变61例,两组比较,年龄、高血压史、吸烟率、糖化血红蛋白、踝肱指数、尿白蛋白/肌酐比值差异有统计学意义;合并下肢或颈动脉粥样硬化患者冠脉病变的发生率显著高于无下肢或颈动脉粥样硬化患者,差异有统计学意义(P<0.0001);多因素logistic回归分析显示,年龄、吸烟史、踝肱指数、颈动脉粥样硬化和下肢动脉粥样硬化为发生冠脉病变显著相关的危险因素。结论对于颈动脉或下肢动脉粥样硬化的2型糖尿病患者,应考虑行冠脉CT检查,以早期诊断、干预冠脉病变。Objective To investigate the relationship between carotid artery atherosclerosis and coronary artery disease in patients with type 2 diabetes mellitus. Methods Totally 204 cases of type 2 diabetes patients were collected. All patients were performed carotid artery and lower extremity artery Doppler ultrasonography and dual source coronary CT. Patients were divided into coronary artery disease group and non-coronary lesion group according to whether the coronary artery had plaque formation or not. Clinical data such as age,sex,blood pressure,smoking history and other clinical data and the results of the laboratory tests of glyco-sylated hemoglobin（ HbA 1c ） ,blood lipids and other laboratory tests were collected. The risk factors of coronary artery disease and the relationship between coronary artery disease and peripheral atherosclerosis were analyzed. Results Among 204 patients with type 2diabetes mellitus,there were 143 patients with coronary artery disease and 61 patients with non-coronary artery disease. The two groups were compared,and age,history of hypertension,smoking rate,glycosylated hemoglobin,ankle brachial index,urinary albumin / creatinine ratio were significantly different. The incidence of coronary artery disease was significantly higher in patients with lower limb or carotid atherosclerosis than in patients without lower limb or carotid artery atherosclerosis（P〈0. 0001）. Multi-variate logistic regression analysis showed that age,smoking history,ankle brachial index,carotid atherosclerosis and lower extremity atherosclerosis were the significant risk factors for coronary artery disease. Conclusion For patients with type 2 diabetes mellitus with carotid or lower extremity atherosclerosis,coronary CT examination should be considered for early diagnosis and intervention of coronary artery disease.

关 键 词：2型糖尿病 动脉粥样硬化 双源CT 

分 类 号：R587.2[医药卫生—内分泌]