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目的:探讨2型糖尿病患者颈总动脉内膜中膜厚度(IMT)和血清超敏C反应蛋白(HS-CRP)的相关性。方法:选取上海市中心城区460例30岁以上已诊断2型糖尿病的患者,采用免疫比浊法测定HS-CRP及用高敏感B型超声仪测定颈总动脉IMT。同时检测身高、体质量、腰围、臀围、血压及空腹血样检查。根据IMT检测结果分为IMT正常组(IMT<1.1mm)317例和IMT增厚组(IMT≥1.1mm)143例。结果:(1)采用Spearman相关分析显示颈总动脉IMT和年龄、病程、BMI、腰围、臀围、收缩压、舒张压、HS-CRP、空腹血糖、餐后2h血糖、糖化血红蛋白、血胆固醇、低密度载脂蛋白呈正相关(相关系数分别为r=0.438、0.182、0.105、0.146、0.116、0.328、0.187、0.217、0.131、0.119、0.093、0.094和0.113,P值均小于0.05。(2)逐步Logistic回归分析显示HS-CRP、年龄、收缩压、空腹血糖、血胆固醇是IMT增厚的独立危险因素(OR=1.048、1.106、1.023、1.354和1.357,P值均小于0.05)。结论:2型糖尿病患者颈总动脉内膜中膜厚度和血清HS-CRP相关,提示炎症可能是大血管病变的机制之一。
Objective: To investigate the relationship between carotid artery intima - media thickness (IMT) and serum high - sensitivity C - reactive protein (HS - CRP) in type 2 diabetic patients. Methods: 460 cases of type 2 diabetes mellitus were diagnosed in over 30 years old in downtown Shanghai. HS-CRP was measured by immunoturbidimetry and carotid artery IMT was measured by high-sensitivity B-mode ultrasound. At the same time testing height, weight, waist circumference, hip circumference, blood pressure and fasting blood test. According to the results of IMT, there were 143 cases of IMT normal group (IMT <1.1mm), 317 cases and IMT thickening group (IMT≥1.1mm). Results: (1) The Spearman correlation analysis showed that the common carotid artery IMT and age, duration, BMI, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, HS-CRP, fasting blood glucose, 2h postprandial blood glucose, glycosylated hemoglobin, Low density lipoprotein (r = 0.438,0.182,0.105,0.146,0.116,0.328,0.187,0.217,0.131,0.119,0.093,0.094 and 0.113, P values were less than 0.05. (2) gradually Logistic regression analysis showed that HS-CRP, age, systolic blood pressure, fasting blood glucose and blood cholesterol were independent risk factors of IMT (OR = 1.048,1.106,1.023,1.354 and 1.357, P values were less than 0.05) .Conclusion: The intima-media thickness of common carotid arteries in patients with diabetes mellitus and serum HS-CRP correlated, suggesting that inflammation may be one of the mechanisms of macrovascular disease.