2型糖尿病合并原发性高血压病患者AASI与颈动脉粥样硬化的相关性分析  

Correlation between ambulatory arterial stiffness index and carotid artery atherosclerosis in patients with type 2 diabetes mellitus and hypertension

作　　者：刘桑燕 杨阳[2] 涂振兴 李烨 王艳 

机构地区：[1]福建中医药大学第五临床医学院三明市第二医院内分泌科,福建永安366000 [2]福建中医药大学第五临床医学院三明市第二医院心内科,福建永安366000

出　　处：《中国当代医药》2017年第32期35-38,42,共5页China Modern Medicine

摘　　要：目的探讨2型糖尿病合并原发性高血压患者动态动脉硬化指数(AASI)的变化,分析其与颈动脉粥样硬化的相关性。方法选取2015年1月~2017年1月我院内分泌科收治的明确诊断且未经治疗的180例2型糖尿病合并原发性高血压患者作为研究对象,根据颈动脉内中膜厚度(IMT)分成IMT正常组(n=51)、IMT增厚组(n=69)、斑块形成组(n=60)。所有患者均检测生化指标、糖化血红蛋白、空腹胰岛素、颈动脉彩超、24 h动态血压等指标,比较三组患者的AASI变化,探讨AASI与颈动脉粥样硬化的相关性。结果 IMT增厚组、斑块形成组患者的SBP、DBP、TG、LDL-C、FPG、HbA1c、FINS、HOMA-IR、UA、Cystatin C明显高于IMT正常组,差异有统计学意义(P<0.01)。斑块形成组患者的SBP、DBP、TG、LDL-C、FPG、HbA1c、FINS、HOMA-IR、UA、Cystatin C均明显高于IMT增厚组,差异有统计学意义(P<0.01)。IMT增厚组、斑块形成组患者的AASI、IMT、RI水平均明显高于IMT正常组,SV、DV水平明显低于IMT正常组,差异有统计学意义(P<0.01)。斑块形成组患者的AASI、IMT、RI明显高于IMT增厚组,SV、DV明显低于IMT增厚组,差异有统计学意义(P<0.01)。单因素相关分析结果提示,IMT与TG、LDL-C、SBP、DBP、PP、FPG、UA、Cystatin C、AASI、RI、年龄均呈明显正相关(r=0.482,0571,0.667,0.509,0.603,0.711,0.386,0.504,0.727,0.623,0.472;P<0.05),与SV、DV呈明显负相关(r=-0.567,-0.611;P<0.01)。多元逐步回归分析结果提示:颈动脉IMT水平与PP、AASI、FPG、UA、LDL-C独立相关(β=1.229,1.442,0.887,1.501,1.884;P<0.05)。结论 2型糖尿病合并原发性高血压患者的AASI水平随着IMT的升高逐渐升高,其水平与颈动脉IMT水平独立相关,可作为颈动脉粥样硬化的预测因子。Objective To investigate the changes of ambulatory arterial stiffness index （AASI） in the type 2 diabetes mellitus and hypertension,and to analysis the correlation between ambulatory arterial stiffness index and carotid artery atherosclerosis.Methods There were 180 patients with type 2 diabetes mellitus and hypertension who were treated in the department of endocrinology in our hospital from January 2015 to January 2017 were selected as subjects for the study.They were divided into there groups （the normal carotid intima-media group, the thickened carotid intima-media group and the plaque formation group） according to carotid intima-media （IMT） thickness.All the patients were tested for biochemical indicators,glycosylated hemoglobin,fasting insulin,carotid artery color ultrasound and 24 hours dynamie blood pressure.The AASI changes of patients in three groups were compared,AASI and the correlation of carotid atherosclerosis were investigated.Result The levels of SBP,DBP,TG,LDL-C,FPG,HbAlc,FINS,HOMA-IR,UA and Cys- tatin C in the thickened carotid intima-media group and the plaque formation group were significantly higher than those in the normal carotid intima-media grouo,and the differences were statistically significant （P〈0.01）.The levels of SBP,DBP,TG,LDL-C,FPG, HbA 1 e,FINS,HOMA-IR,UA and Cystatin C in the plaque formation group were significantly higher than those in the thickened carotid intima-media group,and the differences were statistically significant （P〈0.01）.The levels 0f AASI,IMT and RI in the thickened carotid intima-media group and the plaque formation group were significantly higher than those in the normal carotid intima-media group,while the levels of SV and DV were significantly lower than those in the normal carotid intima-media group,and the differences were statistically significant （P〈0.01）.The levels of AASI,IMT and RI in the plaque formation group were significantly higher than those in the thickened carotid intima-media group,while the levels of SV and DV w

关 键 词：2型糖尿病 原发性高血压 动态动脉硬化指数 颈动脉内中膜厚度 相关性 

分 类 号：R587.1[医药卫生—内分泌]