原发性高血压合并2型糖尿病患者颈动脉内膜中层厚度和踝肱指数分析及与冠状动脉病变程度的相关性  

Correlation between carotid intima-media thickness and ankle brachial index and severity of coronary artery disease in patients with hypertension complicated with type 2 diabetes mellitus

作　　者：何进舟 陈德彬 李东风[1] HE Jin-zhou;CHEN De-bin;LI Dong-feng(Department of Cardiology,the Second People's Hospital of Liu'an,Liu'an Anhui 237000,China)

机构地区：[1]六安市第二人民医院心内科,安徽六安237000

出　　处：《临床和实验医学杂志》2020年第18期1949-1951,共3页Journal of Clinical and Experimental Medicine

基　　金：安徽省高校自然科学研究重点项目(编号:KJ2019A1107)。

摘　　要：目的探讨原发性高血压合并2型糖尿病(T2DM)患者颈动脉内膜中层厚度(IMT)、踝肱指数(ABI)的变化,并分析患者IMT水平和ABI值与冠状动脉病变程度的相关性。方法回顾性选取2017年1月至2018年6月六安市第二人民医院收治的原发性高血压合并T2DM患者117例作为观察组。根据2018年中国高血压防治指南将117例患者分成轻型组(n=39)、中型组(n=41)、重型组(n=37)三个亚组。再选取同期收治的单纯T2DM患者25例作为T2DM组,健康体检者50例作为对照组。分别检测三组的IMT水平和ABI值。采用Pearson相关性分析评价观察组IMT水平和ABI值与冠状动脉病变程度评分(Gensini分数)的相关性。结果观察组IMT水平[(1.17±0.19)mm]高于对照组[(0.79±0.14)mm]和T2DM组[(0.85±0.16)mm],ABI值(1.05±0.12)低于对照组(1.24±0.08)和T2DM组(1.17±0.06),差异具有统计学意义(P<0.05)。轻型组IMT水平[(0.98±0.19)mm]、中型组[(1.31±0.44)mm]、重型组[(1.53±0.49)mm]均高于T2DM组[(0.76±0.14)mm],差异具有统计学意义(P<0.05)。轻型组ABI值(1.04±0.17)、中型组(0.91±0.19)、重型组(0.82±0.15)均低于T2DM组(1.21±0.11),差异具有统计学意义(P<0.05)。其中,中型组IMT水平[(1.31±0.44)mm]高于轻型组[(0.98±0.19)mm],ABI值(0.91±0.19)低于轻型组(1.04±0.17),差异具有统计学意义(P<0.05)。重型组IMT水平[(1.53±0.49)mm]高于中型组[(1.31±0.44)mm]和轻型组[(0.98±0.19)mm],ABI值(0.82±0.15)低于中型组(0.91±0.19)和轻型组(1.04±0.17),差异具有统计学意义(P<0.05)。Pearson相关性分析显示,高血压合并T2DM患者IMT水平与冠状动脉病变程度(Gensini分数)之间呈正相关(r=0.869,P<0.001),ABI值与Gensini分数之间呈负相关(r=﹣0.812,P<0.001)。结论高血压合并T2DM患者有高IMT水平,低ABI值。高血压合并T2DM患者病情越重,IMT水平越高,两者呈正相关;病情越重,ABI值越低,两者呈负相关。Objective To investigate the changes of carotid intima-media thickness(IMT)and ankle brachial index(ABI)in patients with essential hypertension with T2DM,and to analyze the correlation between the levels of IMT and ABI and the degree of coronary artery disease.Methods This study was a retrospective study.117 essential hypertension with T2DM patients diagnosed in the Second People's Hospital of Liu'an City were selected as the observation group from January 2017 to June 2018.They were divided into 3 subgroups:minor subgroup(n=39),medium subgroup(n=41)and severe subgroup(n=37)according to the Chinese hypertension prevention and control guidelines in 2018.25 T2DM patients were selected as T2DM group,and 50 healthy persons were selected as the control group in the same period.The levels of IMT and ABI were detected.Pearson correlation analysis was performed to observe the correlation between the levels of IMT and ABI and the degree of coronary artery disease score.Results The IMT level of the observation group[(1.17±0.19)mm]was higher than the control group[(0.79±0.14)mm]and the T2DM group[(0.85±0.16)mm],and the ABI value(1.05±0.12)was lower than the control group(1.24±0.08)and the T2DM group(1.17±0.06),the difference were statistically significant(P<0.05).The IMT level of minor subgroup[(0.98±0.19)mm],medium subgroup[(1.31±0.44)mm]and severe subgroup[(1.53±0.49)mm]were higher than the T2DM group[(0.76±0.14)mm],the difference were statistically significant(P<0.05).The ABI of minor group(1.04±0.17),medium group(0.91±0.19)and severe group(0.82±0.15)were lower than that of the T2DM group(1.21±0.11),the differences were statistically significant(P<0.05).Among them,the level of IMT(1.31±0.44)mm in the middle group was higher than minor subgroup[(0.98±0.19)mm],and the ABI(0.91±0.19)was lower than minor subgroup(1.04±0.17)(P<0.05).The level of IMT in the severe subgroup[(1.53±0.49)mm]was higher than medium subgroup[(1.31±0.44)mm]and minor subgroup[(0.98±0.19)mm],and the ABI value(0.82±0.15)was lower th

关 键 词：原发性高血压 2型糖尿病 冠状动脉病变 颈动脉内膜中层厚度 踝肱指数 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]