2型糖尿病并发原发性高血压患者冠状动脉Gensini积分、踝肱指数与颈动脉内膜中层厚度的关系分析  

The correlation analysis of Gensini score,ankle brachial index and carotid intima-media thickness in type 2 diabetes mellitus patients complicated with essential hypertension

作　　者：熊启香 颜浩 王玲 XIONG Qi-xiang;YAN Hao;WANG Ling(Third Department of Internal Medicine,Jingzhou Fifth People's Hospital,Jingzhou 434020,China)

机构地区：[1]荆州市第五人民医院内三科,434020

出　　处：《中国实用医药》2023年第24期16-20,共5页China Practical Medicine

摘　　要：目的探讨2型糖尿病(T2DM)并发原发性高血压(EH)患者冠状动脉Gensini积分、踝肱指数(ABI)与颈动脉内膜中层厚度(IMT)的关系。方法回顾性分析226例T2DM并发EH患者的临床资料,根据超声诊断仪测定的IMT将其分为IMT正常组(IMT≤0.9 mm,78例)与IMT增厚组(IMT>0.9 mm,148例)。比较两组患者的临床资料、IMT、冠状动脉Gensini积分、ABI;分析T2DM并发EH患者IMT、冠状动脉Gensini积分及ABI之间的相关性;分析T2DM并发EH患者IMT增厚的影响因素。结果IMT增厚组患者的年龄大于IMT正常组,体质量指数、收缩压、舒张压、吸烟史占比、饮酒史占比、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、低密度脂蛋白胆固醇(LDL-C)高于IMT正常组,T2DM病程、EH病程长于IMT正常组,差异具有统计学意义(P<0.05);两组患者的性别、总胆固醇(TC)、甘油三酯(TG)比较,差异无统计学意义(P>0.05)。IMT增厚组患者的IMT(1.19±0.15)mm大于IMT正常组的(0.81±0.08)mm,冠状动脉Gensini积分(68.33±17.96)分高于IMT正常组的(37.59±14.12)分,ABI(0.97±0.09)小于IMT正常组的(1.18±0.11),差异具有统计学意义(P<0.05)。Pearson相关分析显示,T2DM并发EH患者IMT、冠状动脉Gensini积分与ABI呈负相关性(r=-0.776、-0.892,P<0.05),IMT与冠状动脉Gensini积分呈正相关性(r=0.703,P<0.05)。多因素Logistic回归分析显示,T2DM病程、EH病程、收缩压、舒张压、吸烟史、HbA1c、FPG、LDL-C、冠状动脉Gensini积分、ABI均为T2DM并发EH患者IMT增厚的独立危险因素(P<0.05)。结论T2DM病程、EH病程、收缩压、舒张压、吸烟史、HbA1c、FPG、LDL-C、冠状动脉Gensini积分、ABI均为T2DM并发EH患者IMT增厚的独立危险因素,针对其制定防范措施可有助于预防和治疗T2DM并发EH患者IMT增厚,从而减少心血管疾病的发生。Objective To discuss the correlation of Gensini score,ankle brachial index(ABI)and carotid intima-media thickness(IMT)in type 2 diabetes mellitus(T2DM)patients complicated with essential hypertension(EH).Methods The clinical data of 226 T2DM patients complicated with EH were retrospectively analyzed.According to the IMT measured by ultrasonic diagnostic instrument,they were divided into the IMT normal group(IMT≤0.9 mm,78 cases)and the IMT thickening group(IMT>0.9 mm,148 cases).The clinical data,IMT,coronary artery Gensini score and ABI of the two groups were compared.The correlation of IMT,coronary artery Gensini score and ABI in T2DM patients with EH was analyzed,and the influencing factors of IMT thickening in T2DM patients complicated with EH were analyzed.Results The age of IMT thickening group was longer than that of IMT normal group;the body mass index,systolic blood pressure,diastolic blood pressure,smoking history,drinking history,glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG)and low density lipoprotein cholesterol(LDL-C)in IMT thickening group were higher than those in IMT normal group;the duration of T2DM and EH in IMT thickening group was longer than that in IMT normal group;the differences were statistically significant(P<0.05).There was no statistically significant difference in gender,total cholesterol(TC)and triglyceride(TG)between the two groups(P>0.05).IMT of(1.19±0.15)mm in IMT thickening group was higher than that of(0.81±0.08)mm in IMT normal group;the coronary artery Gensini score of(68.33±17.96)points in IMT thickening group was higher than that of(37.59±14.12)points in IMT normal group;ABI of(0.97±0.09)in IMT thickening group was lower than that of(1.18±0.11)in IMT normal group;the differences were statistically significant(P<0.05).Pearson correlation analysis showed that in T2DM patients complicated with EH,IMT and coronary Gensini scores were negatively correlated with ABI(r=-0.776,-0.892;P<0.05),IMT was positively correlated with coronary artery Gensini scores(r=0.703

关 键 词：冠状动脉Gensini积分 2型糖尿病 原发性高血压 颈动脉内膜中层厚度 

分 类 号：R587.2[医药卫生—内分泌] R544.1[医药卫生—内科学]