病程1年内2型糖尿病患者亚临床动脉粥样硬化的患病特征及影响因素分析  

Analysis of the clinical characteristics of type 2 diabetic patients with a course of less than one year and the influencing factors of carotid intima-media thickness

作　　者：谭艳[1] 夏萃 李祯 刘石平[1] 彭莉红 周智广[1] TAN Yan;XIA Cui;LI Zhen;LIU Shiping;PENG Lihong;ZHOU Zhiguang(Department of Metabolism and Endocrinology&Key Laboratory of Diabetes Immunology,Ministry of Education&National Clinical Research Center for Metabolic Diseases,the Second Xiangya Hospital of Central South University,Changsha,Hunan 410011,China;Department of Endocrinology,the Second People’s Hospital of Hunan Province,Changsha,Hunan 410007,China;Department of Ultrasound,the Second Xiangya Hospital of Central South University,Changsha,Hunan 410011,China)

机构地区：[1]中南大学湘雅二医院代谢内分泌科糖尿病免疫学教育部重点实验室国家代谢性疾病临床医学研究中心,湖南省长沙市410011 [2]湖南省第二人民医院内分泌科,湖南省长沙市410007 [3]中南大学湘雅二医院超声科,湖南省长沙市410000

出　　处：《中国动脉硬化杂志》2020年第8期668-672,687,共6页Chinese Journal of Arteriosclerosis

基　　金：国家重点研发计划项目(2018YFC1315600);湖南省科技计划项目(2017SK2023)。

摘　　要：目的探讨病程1年内2型糖尿病患者的临床特征以及颈动脉内膜中膜厚度(C-IMT)的影响因素,为2型糖尿病患者早期进行大血管并发症的筛查和防治提供科学依据。方法招募代谢内分泌科门诊的病程1年内2型糖尿病患者64例,收集患者人体学参数、血压以及血糖、胰岛功能、血脂、肝肾功能等资料。此外,用彩超检测双侧C-IMT、用双能X骨密度仪检测体脂。按颈动脉彩超的结果,将患者分为非亚临床动脉粥样硬化(As)组(非亚临床As组,16例)和亚临床动脉粥样硬化组(亚临床As组,48例);比较2组患者临床特征的差异,采用二元Logistic回归分析动脉粥样硬化的影响因素。结果64例研究对象中亚临床As的患者占比为75.0%。与非亚临床As组比较,亚临床As组年龄更大、高血压病史占比更高、体质指数更大、血胆固醇更高、低密度脂蛋白更高、代谢综合征占比更高(P<0.05)。相关性分析显示,年龄与内膜中膜厚度呈正相关(r=0.32,P<0.05)。二元Logistic回归分析显示,年龄(OR=1.10)和男性(OR=9.24)是亚临床As组发生的危险因素(P<0.05)。结论即使2型糖尿病被诊断的时间不长,但亚临床动脉粥样硬化的患者占比很高。高龄、男性或合并代谢综合征的2型糖尿病患者更容易发生动脉硬化,更应尽早筛查大血管病变。Aim To investigate the clinical characteristics of type 2 diabetic patients with a course of less than one year and the influencing factors of carotid intima-media thickness(C-IMT),so as to provide scientific basis for early screening and prevention of macrovascular complications in patients with type 2 diabetes(T2 DM).Methods 64 patients with T2 DM with the course less than one year in the outpatient department of metabolism and endocrinology were recruited.Anthropometric parameters,blood pressure,blood glucose,islet function,lipid profile,liver and kidney function were collected.In addition,bilateral C-IMT was detected by color doppler ultrasound and body fat was detected by dual-energy X bone densimeter.According to the results of carotid ultrasound,the patients were divided into non-subclinical atherosclerosis group(16 cases)and subclinical atherosclerosis group(48 cases).The clinical characteristics of the two groups were compared and the influencing factors of atherosclerosis were analyzed by binary Logistic regression.Results The proportion of 64 patients with subclinical was 75.0%.Compared with the non-subclinical atherosclerosis group,the subclinical atherosclerosis group had older age,a higher proportion of history of hypertension,a higher body mass index,higher blood cholesterol,higher LDL,and a higher proportion of metabolic syndrome(P<0.05).The correlation analysis showed that age was positively correlated with the thickness of the medial membrane(r=0.32,P<0.05).Binary Logistic regression analysis showed that age(OR=1.10)and male(OR=9.24)were risk factors for subclinical atherosclerosis(P<0.05).Conclusion Subclinical atherosclerosis accounts for a high proportion of patients even though the duration is not long.Type 2 diabetic patient with elderly,male or metabolic syndrome are more likely to develop atherosclerosis,so it is more important for them to screen for macrovascular lesions as early as possible.

关 键 词：2型糖尿病 颈动脉内膜中膜厚度 亚临床动脉粥样硬化 影响因素 

分 类 号：R5[医药卫生—内科学]