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目的应用高频超声探讨2型糖尿病患者血糖控制不良对动脉硬化的影响。方法采用彩色多普勒超声仪由专人在单盲条件下测量35例血糖良好控制及38例血糖长期控制不满意的2型糖尿病患者双侧颈动脉血管内膜中层厚度,并进行动脉粥样斑块评分。结果无论是颈动脉内膜中层厚度还是粥样斑块评分,血糖控制良好组均明显优于血糖控制不良组(内膜中层厚度比较:P<0.005;粥样斑块评分比较:P<0.05);血糖控制良好组血清三酰甘油水平及平均动脉压均较血糖控制不良组低(P均<0.001),但血清总胆固醇水平两组差异无统计学意义(P>0.05);直线相关分析发现入选糖尿病患者颈动脉内膜中层厚度与患者的空腹血糖及糖化血红蛋血Alc水平呈正相关关系(P<0.005),等级相关分析发现粥样斑块评分与空腹血糖水平正相关(P<0.05),与糖化血红蛋血Alc水平相关关系接近,差异有统计学意义(P<0.083)。结论长期血糖控制不满意加速2型糖尿病患者动脉粥样硬化的发生发展,高血糖本身或通过血脂代谢异常及血压升高促进2型糖尿病患者动脉硬化发生,持续而有效的血糖控制是本病患者治疗的首要措施。
Objective To investigate the effect of poor glycemic control on arteriosclerosis in patients with type 2 diabetes by high frequency ultrasound. Methods The color Doppler ultrasound system was used to measure the bilateral carotid artery intima-media thickness in 35 patients with type 2 diabetes mellitus under long-term control of blood glucose and 38 patients under long-term control of blood glucose. Atherosclerosis Block score. Results No matter carotid artery intima-media thickness or atherosclerotic plaque score, the control group with good glycemic control were significantly better than the control group with poor glycemic control (intima-media thickness: P <0.005; atherosclerotic plaque score: P <0.05) (P <0.001). However, there was no significant difference in serum total cholesterol levels between the two groups (P> 0.05). The linear correlation analysis showed that There was a positive correlation between carotid artery intima-media thickness and fasting blood glucose and glycosylated hemoglobin A1c level (P <0.005), and rank correlation analysis showed that atherosclerotic plaque score positively correlated with fasting blood glucose level (P <0.05) (P <0.083), which was close to that of glycosylated hemoglobin A1c. Conclusions Dissatisfied with long-term glycemic control, accelerated the development of atherosclerosis in patients with type 2 diabetes. Hyperglycemia itself or atherosclerosis in patients with type 2 diabetes mellitus may be caused by dyslipidemia and high blood pressure. Persistent and effective glycemic control The first measure of treatment.