2型糖尿病大血管病变患者血清同型半胱氨酸及颈动脉内膜中层厚度分析  

Clinical Significance of Serum Homocysteine Level and Carotid Intima-Media Thickness in Patients with Type 2 Diabetic Macroangiopathy

作　　者：赵香君 陈海超 佟成成 周颖 孙学胜 牟晓乐 ZHAO Xiangjun;CHEN Haichao;TONG Chengeheng;ZHOU Ying;SUN Xuesheng;MOU Xiaole(Department of General Medicine;Department of Geriatrics;Department of General Surgery,Qinhuangdao Military Industrial Hospital,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛军工医院综合内科,河北秦皇岛066000 [2]秦皇岛军工医院老年病科,河北秦皇岛066000 [3]秦皇岛军工医院普通外科,河北秦皇岛066000

出　　处：《医学综述》2018年第19期3950-3953,共4页Medical Recapitulate

基　　金：秦皇岛市科学技术研究与发展计划(201703A043)

摘　　要：目的分析2型糖尿病(T2DM)大血管病变患者血浆同型半胱氨酸(Hcy)水平及颈动脉内膜中层厚度(IMT)。方法选择2016年1月至2017年6月秦皇岛军工医院收治的120例T2DM患者为研究对象,按照是否合并大血管病变分为病变组(n=65)和无病变组(n=55),选择同期60名健康体检者作为正常对照组。比较三组受试者糖化血红蛋白(Hb A1c),血脂[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)],以及血浆Hcy和IMT。结果病变组和无病变组患者的Hb A1c、TG、TC及LDL-C水平高于正常对照组,HDL-C水平低于正常对照组(P<0.05);病变组患者的Hb A1c、TG、TC及LDL-C水平高于无病变组,HDL-C水平低于无病变组(P<0.05)。病变组和无病变组患者Hcy和IMT明显高于正常对照组,病变组患者Hcy和IMT高于无病变组(P<0.05)。结论血清Hcy水平及IMT在T2DM大血管病变的发生、发展中有重要作用,早期检测血清Hcy水平及IMT可为T2DM大血管病变患者早期诊断和临床治疗提供新思路。Objective To investigate the clinical significance of serum homocysteine （Hcy） level and carotid artery intima-media thickness（IMT） in type 2 diabetes mellitus（T2DM） patients with macrovascular lesions. Methods A total of 120 cases of T2DM treated in in the Qinhuangdao Militry Industrial Hospital from Jan. 2016 to Jun. 2017 were included in the study. They were divided into a lesion group（ n = 65 ） and a non-lesion group（ n = 55 ） according to whether there was macroangiopathy, and 60 healthy persons during the sane period were included as a normal control group. The glycosylated hemoglobin （ HbA1c ） and blood lipid [ total cholesterol （ TC ）, triglyceride （ TG）, high density- lipoprotein cholesterol （ HDL-C ）, low density lipoprotein cholesterol（ LDL-C ） 1 , plasma Hcy, and IMT were compared between the three groups. Results The levels of HbA1c ,TG,TC and LDL-C in the lesion group and non-lesion were higher than those in the normal control group （P 〈 0.05 ） , and the levels of HbA1c TG, TC and LDL-C in the lesion group were higher than those in thenon-lesion group, while the level of the HDL-C was lower than that of the non-lesion group （P 〈 0.05 ）. The levels of Hcy and IMT in the lesion group and the non-lesion group were significantly higher than those in the normal control group, and the Hcy and IMT in the lesion group were higher than those in the non-lesion group （ P 〈 0.05 ）. Conclusion Hcy levels and IMT play important roles in the development and progression of macrovascular lesions in T2DM. Early detection of serum Hcy levels and IMT thickness may offer useful references for the early detection and treatment of macrovascular lesions in T2DM.

关 键 词：2型糖尿病 大血管病变 同型半胱氨酸 颈动脉内膜中层厚度 

分 类 号：R587.2[医药卫生—内分泌]