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目的探讨新诊断2型糖尿病患者颈动脉粥样硬化的患病情况以及相关危险因素分析。方法选取新诊断的2型糖尿病患者321例,根据有无颈动脉粥样硬化分为颈动脉正常组(118例)和颈动脉粥样硬化组(203例)。测量身高、体重、血压,检测糖脂代谢指标以及胰岛功能,颈动脉B超测定颈动脉粥样硬化斑块。结果①新诊断的2型糖尿病患者中,合并有颈动脉粥样硬化的患者占63%,其发病平均年龄为(53.99±10.87)岁,男性患者占72.4%,女性占27.6%;合并超重/肥胖患者占59.6%,高血压患者占33.2%,脂肪肝患者占78.6%。②与无颈动脉粥样硬化的患者相比,合并颈动脉粥样硬化的新诊断T2DM患者的年龄较大,合并高血压的比例较高,收缩压、低密度脂蛋白水平以及胰岛素抵抗指数较高,差异有显著性(P<0.05);而两组间的BMI、DBP、FPG、PPG、FINS、PINS、HBA1C、TG、TC、HDL-C、HOMA-β无明显差异(P>0.05)。③按糖化血红蛋白水平分层后没有发现糖化血红蛋白与颈动脉粥样硬化的相关性(P>0.05)。④logistic分析,校正年龄、性别后,结果显示SBP是影响新诊断2型糖尿病患者颈动脉粥样硬化的独立危险因素。结论新诊断的2型糖尿病患者中大部分已存在颈动脉粥样硬化,早期发现和干预颈动脉病变将延缓动脉粥样硬化的进程,从而有利于改善糖尿病患者的预后。
Objective To investigate the prevalence of carotid atherosclerosis in newly diagnosed type 2 diabetic patients and the related risk factors. Methods A total of 321 newly diagnosed type 2 diabetic patients were selected and divided into two groups based on the presence or absence of carotid atherosclerosis: normal carotid artery (118 cases) and carotid atherosclerosis (203 cases). Measurement of height, weight, blood pressure, glucose and lipid metabolism indicators as well as pancreatic islet function, carotid artery B-carotid atherosclerotic plaque was measured. Results ① The newly diagnosed patients with type 2 diabetes mellitus accounted for 63% with carotid atherosclerosis, with an average age of (53.99 ± 10.87) years, accounting for 72.4% in males and 27.6% in females. The patients with combined overweight / Fat patients accounted for 59.6%, hypertension patients accounted for 33.2%, fatty liver patients accounted for 78.6%. ② Compared with patients without carotid atherosclerosis, newly diagnosed T2DM patients with carotid atherosclerosis had a higher proportion of older and higher blood pressure, systolic blood pressure, low density lipoprotein, and insulin resistance index (P <0.05). There was no significant difference in BMI, DBP, FPG, PPG, FINS, PINS, HBA1C, TG, TC, HDL- . (3) HbAlc was not associated with carotid atherosclerosis after stratification by HbA1c level (P> 0.05). ④Logistic analysis, age and gender were adjusted. The results showed that SBP was an independent risk factor for newly diagnosed type 2 diabetes patients with carotid atherosclerosis. Conclusion Most newly diagnosed patients with type 2 diabetes mellitus have carotid atherosclerosis. Early detection and intervention of carotid artery disease will delay the process of atherosclerosis, which will help to improve the prognosis of diabetic patients.