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目的探讨颈动脉彩色多普勒超声检查在中老年糖尿病中的价值。方法 2010年3月至7月对上海市嘉定区菊园新区2504名40岁以上居民按照1999年WHO诊断标准分为糖调节正常组(1389名)、糖调节异常组(730例)及糖尿病组(385例)。所有研究对象均接受身高、体重和血压等体格检查,进行75 g葡萄糖耐量试验和颈动脉B型超声检查,并检测血脂。结果 (1)从糖调节正常组到糖调节异常组,再到糖尿病组,CIMT逐渐增高,CIMT增厚及颈动脉斑块的发生率均显著增加(P均<0.05)。(2)与糖调节正常组相比,糖尿病组CIMT增厚及颈动脉斑块的患病危险度均增高,在校正年龄、性别、BMI、收缩压、舒张压以及血脂等混杂因素后,显著性依然存在,OR(95%CI)分别为1.17(1.02~1.34)和1.21(1.01~1.47)。结论上海市城镇40岁以上社区居民中,糖尿病与CIMT增厚及颈动脉斑块显著相关。在糖尿病人群中,定期进行颈动脉彩色多普勒超声检查,早期发现动脉粥样硬化,对预防糖尿病患者心血管并发症的发生具有重要的价值。
Objective To investigate the value of carotid artery color Doppler ultrasonography in middle-aged and elderly patients with diabetes mellitus. Methods From March to July 2010, 2504 residents over 40 years old in Juyuan New Area, Jiading District, Shanghai were divided into three groups according to the 1999 WHO diagnostic criteria: normal glucose control group (1389), abnormal glucose regulation group (730 cases) and diabetic group (385 cases). All subjects underwent physical examinations such as height, weight and blood pressure, and had 75 g glucose tolerance test and carotid artery type B ultrasound examination, and blood lipids were measured. Results (1) CIMT gradually increased, CIMT thickened and carotid plaque incidence increased significantly (P <0.05) from the normal glucose control group to the abnormal glucose regulation group to the diabetic group. (2) Compared with the normal control group, the thickening of CIMT and the risk of carotid artery plaque in diabetes mellitus group were all higher than those in normal control group. After adjusting for age, sex, BMI, systolic blood pressure, diastolic blood pressure and blood lipid, Sex remained, with OR (95% CI) of 1.17 (1.02-1.34) and 1.21 (1.01-1.47), respectively. Conclusions Diabetes is significantly associated with thickening of CIMT and carotid plaque in urban residents over 40 years of age in urban areas of Shanghai. Carotid color Doppler ultrasonography is a routine measure of diabetes mellitus and early detection of atherosclerosis is of great value in the prevention of cardiovascular complications in diabetic patients.