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目的 探讨 2型糖尿病 (DM)患者颈动脉内膜中层厚度 (IMT)改变及与各种危险因子的关系。方法 对 5个年龄组 12 3例 DM患者和 10 2例正常人行超声波 IMT检测 ,并对界值上下两组 DM患者临床数据进行比较。结果 1DM患者与正常人 IMT均随年龄增长而增厚 ,各年龄组 DM患者 IMT均较正常人明显增厚 (P<0 .0 5～ P<0 .0 1) ,30岁～、40岁～组 DM病人与 5 0岁～、6 0岁～组正常人 IMT相似。 2正常人 IMT为 0 .6 1± 0 .0 7mm,其中 98%为 <0 .8mm;DM患者 IMT为 0 .85± 0 .2 1mm,其中 5 6 %为≥ 0 .8mm。 3DM患者 IMT≥ 0 .8mm组的收缩压、舒张压、高血压病程、空腹胰岛素、2 4小时尿白蛋白、CHD及 CVD发生率明显增高 ,胰岛素敏感指数却明显低于 IMT<0 .8mm组 (P<0 .0 5～ P<0 .0 1) ,而空腹血糖、餐后 2小时血糖、2小时胰岛素、Hb A1c、胆固醇、甘油三酯两组间无显著性差异。结论 DM患者 IMT增厚早、进展快 ,IMT≥ 0 .8mm的 DM患者心脑血管病危险增加。尿白蛋白增加是 IMT增厚的标志。高血压、高胰岛素血症、胰岛素抵抗对动脉粥样硬化的促进作用从早期即存在影像学的证据。
Objective To investigate the relationship between carotid intima-media thickness (IMT) and various risk factors in type 2 diabetes mellitus (DM). Methods Ultrasound IMT was performed in 123 DM patients and 102 normal controls in 5 age groups. The clinical data of DM patients in the two upper and lower boundary groups were compared. Results The IMT in both 1DM patients and normal controls were increased with age, and the IMT in DM patients of all age groups was significantly thicker than that of normal people (P <0.05 ~ P <0.01), 30 ~ 40 years old ~ Group DM patients and 50 years old, 60 years old ~ normal IMT group similar. 2 The normal IMT was 0.61 ± 0.0 7mm, of which 98% was <0.8mm; the IMT of DM patients was 0.85 ± 0.21mm, of which 56% were ≥0.8mm. Systolic blood pressure, diastolic blood pressure, duration of hypertension, fasting insulin, 24-hour urinary albumin, CHD and CVD in IMT≥0.8mm group were significantly higher in patients with 3DM, but insulin sensitivity index was significantly lower than IMT <0.8mm group (P <0.05 ~ P <0.01). However, there was no significant difference between fasting blood glucose, 2 hours postprandial blood glucose, 2 hours insulin, Hb A1c, cholesterol and triglyceride. Conclusion DM patients with early IMT thickening, rapid progress, IMT ≥ 0.8mm DM patients with increased risk of cardiovascular and cerebrovascular disease. Increased urinary albumin is a sign of IMT thickening. Hypertension, hyperinsulinemia, insulin resistance on the role of atherosclerosis promotion from early that there is imaging evidence.