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目的探讨新诊断2型糖尿病合并动脉粥样斑块的发病情况及影响因素。方法对538例新诊断的2型糖尿病患者行颈总动脉、髂总动脉、股动脉超声筛查,根据超声结果分为无斑块组425例(内中膜厚度IMT≤1.3 mm)及斑块组113例(内中膜厚度IMT>1.3 mm),观察两组间年龄、性别、腰围、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、餐后2 h血糖(2hBG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)的差异及危险因素。结果①538例新诊断2型糖尿病患者动脉斑块发病率为28.6%;无斑块组颈总动脉、髂总动脉、股动脉IMT分别为(0.74±0.17)mm(、0.74±0.15)mm和(0.74±0.17)mm,斑块组颈总动脉、髂总动脉、股动脉IMT分别为(0.91±0.23)mm、(0.94±0.21)mm和(0.88±0.22)mm,且两组间各动脉的IMT差异具有统计学意义(P<0.05);②斑块组年龄、腰围、BMI、SBP、DBP、FBG2、hBG、HbA1C、HOMA-IR、TG、TC和LDL-C平均水平均比非斑块组高(P<0.05),其中两组间年龄、SBP、FBG、2hBG、TG和LDL-C的差异有统计学意义(P<0.05);③多元逐步回归分析结果显示,年龄、SBP、2h-PBG和TG为新诊断2型糖尿病患者颈总动脉、髂总动脉、股动脉斑块发生的主要危险因素。结论新诊断2型糖尿病动脉斑块发病率高,仅行颈动脉超声检测漏诊率高,糖代谢异常及脂质代谢紊乱对动脉粥样硬化的发生、发展起着重要作用。
Objective To investigate the incidence and influencing factors of newly diagnosed type 2 diabetes with atherosclerotic plaques. Methods 538 newly diagnosed patients with type 2 diabetes mellitus underwent ultrasound screening of the common carotid artery, common iliac artery and femoral artery. According to the results of ultrasound, there were 425 patients without plaque (IMT≤1.3 mm) and plaque (IMT> 1.3 mm) of the intima - media thickness (IMT) group were observed. The age, sex, waist circumference, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose HbA1c, HOMA-IR, TG, TC, LDL-C and HDL were measured at the end of the second month after 2 h of treatment. Differences in protein cholesterol (HDL-C) and risk factors. Results ① The incidence of arterial plaque in newly diagnosed type 2 diabetic patients was 28.6% in 538 cases. The IMT of common carotid artery, common iliac artery and femoral artery in non-plaque group were (0.74 ± 0.17) mm (, 0.74 ± 0.15) mm and 0.74 ± 0.17) mm. The IMT of common carotid artery, common iliac artery and common femoral artery in plaque group were (0.91 ± 0.23) mm, (0.94 ± 0.21) mm and (0.88 ± 0.22) mm, respectively IMT had statistical significance (P <0.05) .②The mean levels of age, waist circumference, BMI, SBP, DBP, FBG2, hBG, HbA1C, HOMA-IR, TG, TC and LDL- (P <0.05). The differences of age, SBP, FBG, 2hBG, TG and LDL-C between the two groups were statistically significant (P <0.05) .③Multivariate stepwise regression analysis showed that age, SBP, -PBG and TG are newly diagnosed type 2 diabetes patients with common carotid artery, common iliac artery, femoral artery plaque occurred in the main risk factors. Conclusions The incidence of arterial plaque in newly diagnosed type 2 diabetes mellitus is high. Only the rate of misdiagnosis of carotid ultrasonography, abnormal glucose metabolism and dyslipidemia play an important role in the development of atherosclerosis.