目的探讨Ⅱ型糖尿病患者颈动脉超声结构和功能改变及相关危险因素的关系。方法连续调查60岁以上老人354例,男190例;女164例。年龄(69.3±6.6)岁,其中糖尿病合并高血压(DM-EH)100例;糖尿病组(DM)45例;高血压病组(EH)162例;同龄正常对照组47例。应用高分辨彩色多普勒-B型超声检测颈动脉及相关临床检查。经SPSS10软件统计分析。结果颈动脉内-中膜厚度(IMT)DM-EH组,DM组比对照组显著增厚(P均<0.01);其中IMT>1.3mm在各组的构成比依次为76.0%,66.7%,64.4%,20.0%;各组间差异非常显著(P均<0.01)。斑块的发生率各组依次为64.6%,57.7%,37.8%,26.7%;各组间差异非常显著(P均<0.01)。颈总动脉和颈内动脉内径:DM-EH、EH组、DM组均较对照组显著增宽(P均<0.05);EH组较DM组均显著增宽(P均<0.05);DM-EH组与EH组间无显著性差异(P均<0.05)。收缩期血流峰速度和舒张期血流峰速度:对照组、DM组、EH组、DM-EH组依次减慢;DM组、EH组、DM-EH组较对照组差异均非常显著(P均<0.01)。多元逐步回归表明:IMT与斑块积分、年龄、空腹血糖、脉压正相关。结论颈动脉IMT厚度与斑块积分,空腹血糖,年龄和脉压密切相关;IMT与斑块积分是DM合并大血管病变的重要的超声标识。 Objective To investigate the relationship between the structure and function of carotid artery in patients with type 2 diabetes mellitus and the related risk factors. Methods A total of 354 elderly people over the age of 60 were investigated, including 190 males and 164 females. (69.3 ± 6.6) years old, of whom 100 were diabetes mellitus with hypertension (DM-EH), 45 were diabetes mellitus (DM), 162 were hypertensive disease group (EH), and 47 were the same age normal control group. Application of High Resolution Color Doppler Ultrasound in the Diagnosis of Carotid Artery and Related Clinical Examination. SPSS10 software statistical analysis. Results The carotid intima - media thickness (IMT) DM - EH group and DM group were significantly thicker than the control group (all P <0.01). The IMT> 1.3mm in each group were 76.0%, 66.7% 64.4% and 20.0%, respectively. The differences among the groups were significant (all P <0.01). The incidence of plaques was 64.6%, 57.7%, 37.8% and 26.7% in each group, with significant differences among the groups (all P <0.01). The diameters of carotid artery and internal carotid artery were significantly increased in DM-EH, EH and DM groups as compared with those in control group (all P <0.05) There was no significant difference between EH group and EH group (all P <0.05). The systolic peak velocity and diastolic peak velocity were significantly lower in DM group, EH group and DM-EH group than those in control group, DM group, EH group and DM-EH group (P All <0.01). Multivariate stepwise regression showed that IMT was positively correlated with plaque score, age, fasting blood glucose and pulse pressure. Conclusion IMT thickness of carotid artery is closely related to plaque score, fasting blood glucose, age and pulse pressure. IMT and plaque score are important ultrasonic markers for DM complicated with macrovascular disease.