2型糖尿病病人大动脉僵硬度相关危险因素研究  

Arterial stiffness in type 2 diabetic patients and its related factors

作　　者：王君玓 商广芸[3] 何为[1] 王宏宇[3] 

机构地区：[1]北京大学第三医院放射科,北京100191 [2]北京市第一中西医结合医院放射科,北京100021 [3]北京大学首钢医院血管医学科,北京100144

出　　处：《首都医科大学学报》2017年第5期740-743,共4页Journal of Capital Medical University

基　　金：北京市卫生局首都卫生发展科研专项(首发2011-4026-02);北京大学首钢医院院内基金(SGYY201406)~~

摘　　要：目的探讨分析2型糖尿病病人大动脉僵硬度及其相关危险因素。方法选取北京大学首钢医院2013年9月至2016年9月间收治的582例2型糖尿病病人作为观察组研究对象,同时选取来医院进行常规体检的384名正常人群为对照组,对两组研究对象行一般资料收集、颈动脉超声和脉搏波传导速度检查,观察比较两组检查结果。结果观察组病人收缩压、三酰甘油(triglyceride,TG)、体质量指数(body mass index,BMI)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、胰岛素抵抗指数、C反应蛋白(C reactive protein,CRP)、同型半胱氨酸都高于对照组,高密度脂蛋白胆固醇(high density lipoproteincholesterol,HDL-C)低于对照组,两组差异有统计学意义(P<0.05)。观察组病人颈动脉内中膜厚度(intima-media thickness,IMT)、颈-股动脉脉搏波传导速度(carotid-femoral pulse wave velocity,CF-PWV)高于对照组(P<0.05),其中观察组单侧斑块检出率为47.59%,对照组为14.22%,观察组双侧颈动脉斑块检出率为33.85%,对照组为5.47%,单、双侧观察组均高于对照组,两组差异有统计学意义(P<0.05)。对2型糖尿病病人脉搏波传导速度进行Logistic回归分析得知,年龄、收缩压、LDL-C、胰岛素抵抗指数、CRP是影响大动脉僵硬度的主要因素。结论 2型糖尿病病人中高血压、高脂血症的发生率明显高于正常人群,颈动脉更易生长斑块,且大动脉弹性明显减退,影响其僵硬度的因素有年龄、收缩压、LDL-C、胰岛素抵抗指数、CRP等。应在治疗中严格控制多重危险因素,提高治疗效果,改善病人生活质量。Objective To explore type 2 diabetes mellitus and arterial stiffness related factors. Methods A total of 582 cases of patients with type 2 diabetes in our hospital from September 2013 to September 2016 as the research objects of the observation group,and selected 384 healthy people in our hospital were enrolled as the control group. Carotid artery ultrasound and pulse wave velocity of the two groups were checked,test results were observed. Results Observation group of patients with systolic blood pressure（SBP）,triglyceride（TG）,body mass index（BMI）,low density lipoprotein-cholesterol（LDL-C）,insulin resistance index,C reactive protein（CRP）,homocysteine was higher than that of the control group,high density lipoprotein-cholesterol（HDL-C） was lower than that in the control group,there was statistically significant correlation between the two groups（P〈0. 05）. The observation group patients with carotid artery intima-media thickness（IMT）,carotid-femoral pulse wave velocity（CF-PWV） higher than that of the control group（P〈0. 05）,the observation group with the plaque detection rate was 47. 59%,the control group with the plaque detection rate was 14. 22%,the observation group of bilateral carotid artery plaque detection rate was 33. 85%,the control group of bilateral carotid artery plaque detection rate was 5. 47%,the two groups had significant difference（P〈0. 05）. Analysis of patients with type 2 diabetes mellitus,Logistic regression analysis showed that age,SBP,LDL-C,homeostasis model assessment of insulin resistance（HOMA-IR）,and CRP were the major factors affecting the arterial stiffness. Conclusion In patients with type 2 diabetes and hypertension,hyperlipidemia wassignificantly higher than that in normal group,carotid artery plaque growth more easily,and large artery elasticity decreased obviously,the influence factors of the stiffness are age,SBP,LDL-C,HOMA-IR and CRP. We should strictly control multiple risk factors in the treatment,improve the treatment effect a

关 键 词：2型糖尿病 颈动脉内中膜厚度 脉搏波传导速度 相关因素 

分 类 号：R587.1[医药卫生—内分泌]