糖尿病颈动脉、椎动脉硬化斑块发生率及相关因素分析  

The study of the probability and clinical significance of carotid and vertebral atherosclerotic plaque in diabetes

作　　者：张新义[1] Zhang Xinyi(Functional Inspection Division,Taiyuan Central Group Hospital,Taiyuan,Shanxi 030006,China)

机构地区：[1]太原市中铁三局集团中心医院功能检查科,山西省太原030006

出　　处：《中国基层医药》2018年第21期2804-2807,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨糖尿病（DM）患者颈动脉、椎动脉硬化斑块发生率及相关因素。方法选择2012年9月至2017年9月太原市中铁三局集团中心医院诊治的DM患者465例为研究对象，应用彩色多普勒超声对465例DM患者进行检查，统计颈动脉斑块、椎动脉斑块的发生率，logistic回归分析DM患者动脉硬化斑块形成和不良结局的危险因素。结果共检出351例存在动脉斑块患者，检出率75.48%，其中颈动脉69.23%，椎动脉60.97%，61～70岁占93.65%，空腹血糖〉15.0 mmol/L患者中有79.17%，DM病程〉10年患者中有97.80%检出动脉斑块，动脉斑块组与无动脉斑块组在年龄、空腹血糖水平、病程差异均有统计学意义（χ^2＝10.564、9.165、10.285，均P〈0.05）；29例DM伴动脉斑块患者发生不良结局事件，不良结局患者空腹血糖水平（15.26±5.93）mmol/L，斑块积分（2.59±0.68）分，与未发生不良结局DM比较差异均有统计学意义（t＝5.646、3.964，均P〈0.05）；logistic回归分析显示：年龄≥61岁、空腹血糖≥10.1 mmol/L、病程≥5年为DM患者动脉斑块形成的危险因素，其OR值分别为1.592（95%CI：1.160～4.237）、2.263（95%CI：0.952～8.859）、1.095（95%CI：2.963～10.763）；空腹血糖水平≥15.0 mmol/L、斑块积分〉2分为DM不良预后危险因素，其OR值分别为：3.592（95%CI：0.956～6.261）、2.913（95%CI：1.238～9.238）。结论DM患者有较高的颈动脉、椎动脉斑块发生风险，血糖水平越高，斑块积分越高，预后越差。Objective To investigate the probability and clinical significance of carotid and vertebral atherosclerotic plaque in patients with diabetes mellitus （DM）.Methods From September 2012 to September 2017, 465 patients with DM in Taiyuan Central Group Hospital were examined by color Doppler ultrasound.The incidence of carotid plaque, vertebral artery plaque was analyzed, logistic regression analysis was used to analyze the risk factors of atherosclerosis formation and adverse outcomes in DM patients.Results There were 351 cases of arterial plaques, the detection rate was 75.48%, including 69.23% of carotid arteries, 60.97% of vertebral arteries, 61-70 years old accounted for 93.65%, patients with fasting blood glucose 〉15.0 mmol/L accounted for 79.17%, DM patients with the course of more than 10 years accounted for 97.80% of detectable arterial plaque.The age, fasting blood glucose level, duration had statistically significant differences between the plaque group and non plaque group （F=10.564, 9.165, 10.285, all P〈0.05）. Adverse outcomes were observed in 29 DM patients with arterial plaque.The fasting blood glucose level[（15.26±5.93）mmol/L], plaque score [（2.59±0.68）points] in patients with adverse outcomes had statistically significant differences compared with DM patients without adverse outcomes （t=5.646, 3.964, all P〈0.05）. The Results of logistic regression analysis showed that age over 61 years, fasting blood glucose more than 10.1mmol/L, duration of DM more than 5 years were risk factors of plaque formation in DM patients, the OR values were 1.592 （95% CI： 1.160～4.237）, 2.263 （95% CI： 0.952～8.859）, 1.095 （95% CI： 2.963～10.763）. The fasting blood glucose level≥15.0mmol/L, plaque score〉2points were risk factors of poor prognosis of DM patients, the OR values were 3.592 （95% CI： 0.956～6.261）, 2.913 （95% CI： 1.238～9.238）.Conclusion Patients with DM has a higher risk of carotid artery and vertebral artery plaque, the higher the blood sugar le

关 键 词：糖尿病 颈动脉 椎动脉 动脉硬化 

分 类 号：R587.2[医药卫生—内分泌]