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采用飞利浦iuzz型彩色多普勒超声检查仪对137例2型糖尿病(T2DM)患者进行颈动脉血管检测,按颈动脉病变情况将其分为T2DM合并动脉硬化(AS)组及单纯糖尿病组(T2DM组),并设健康对照组,分析颈动脉粥样硬化与年龄、糖尿病病程、血糖、血压、甘油三脂(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),尿酸(UA)、24小时尿蛋白定量(U-AER)、纤维蛋白原(FIB)、HbA1c、胰岛素敏感指数(IAI)、体重指数(BMI)的相关性。结果:三个组的年龄两两之间均有统计学差异(P<0.05);性别构成、BMI无统计学差异。T2DM-AS组与单纯T2DM组比较,病程、高血压例数、TG、HDL-C、LDL-C、FIB、HbA1c差异均有统计学意义(P<0.05);其余指标差异无统计学意义。T2DMAS组与对照组比较,TG、HDL-C、LDL-C、UA、FPG、PPG、IAI、U-AER、FIB、HbA1c、SPB、DPB差异有统计学意义;其余指标差异无统计学意义。单纯T2DM组与对照组比较,LDL-C、FPG、PPG、IAI、HbA1c、SBP、DBP差异均有统计学意义(P<0.05);其余指标差异无统计学意义。Logistic回归分析提示糖尿病病程、有高血压、LDL-C等3个变量是颈动脉病变的危险因素,即其数值越大则越容易发生颈动脉病变;HDL-C是颈动脉病变的保护因素,其数值越大则越不容易发生颈动脉病变。结论:糖尿病合并大血管病变是多因素综合作用的结果,防治糖尿病颈动脉粥样硬化应同时进行多因素全面控制。
Carotid artery was detected in 137 patients with type 2 diabetes mellitus (T2DM) by Philips iuzz color Doppler ultrasonography. According to the carotid artery disease, they were divided into two groups: T2DM with arteriosclerosis (AS) group and T2DM Group), and healthy control group. The carotid atherosclerosis and age, diabetes duration, blood glucose, blood pressure, TG, TC, HDL-C, LDL-C, UA, UAER, FIB, HbA1c, insulin sensitivity index (IAI) and body mass index (BMI) . Results: There was a significant difference between the two groups in age (P <0.05). There was no significant difference in gender composition and BMI between the two groups. The duration of disease, the number of hypertension, TG, HDL-C, LDL-C, FIB and HbA1c in T2DM-AS group were significantly different from those in T2DM group only (P <0.05). There was no significant difference in other indexes. The differences of TG, HDL-C, LDL-C, UA, FPG, PPG, IAI, U-AER, FIB, HbA1c, SPB and DPB between T2DMAS group and control group were statistically significant; Compared with the control group, the levels of LDL-C, FPG, PPG, IAI, HbA1c, SBP and DBP were all significantly different in T2DM group (P <0.05). There was no significant difference in other indexes. Logistic regression analysis showed that diabetes duration, hypertension, LDL-C and other three variables were risk factors of carotid artery disease, that is, the greater the value, the more prone to carotid artery disease. HDL-C was the protective factor of carotid artery disease, The greater the value of the less prone to carotid artery disease. Conclusion: The diabetic macroangiopathy is a multifactorial combination of the results of the prevention and treatment of diabetes, carotid atherosclerosis should be multi-factor comprehensive control at the same time.