摘要
目的探讨影响2型糖尿病患者颈动脉硬化的多个影响因素。方法收集110例2型糖尿病患者采用彩色多普勒超声诊断仪10 MHz高频探头检测患者双侧颈动脉。按超声检查结果分为4组:颈动脉正常组20例[双侧颈动脉内膜中层厚度(IMT)<0.9 mm];颈动脉内膜增厚组30例(0.9 mm≤IMT≤1.3 mm);稳定斑块组45例(斑块呈强回声,伴或不伴声影);不稳定斑块组15例(斑块呈略低回声,内部或周边有强回声附着)。留取患者空腹血清采用酶联免疫吸附试验(ELISA)测定胰岛素(Ins)、胰岛素原(PI)、可溶性血管细胞间黏附分子-1(sVCAM-1),并同时测定糖化血红蛋白(HbA1c)、血脂系列、C反应蛋白(CRP)及尿微量白蛋白。全部统计资料采用SPSS11.0统计软件进行方差分析、q检验。以颈动脉粥样硬化程度评分为应变量,分别以年龄、甘油三酯(TG)等为自变量做多元逐步回归分析。结果4组间HbA1cI、ns、PI、体重指数(BMI)、CRP等差异无统计学意义;而颈动脉内膜增厚组、稳定斑块组、不稳定斑块组的年龄、TG、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(CHO)及sVCAM-1明显高于颈动脉正常组,且差异有统计学意义,P均<0.01。多元回归分析结果显示患者的年龄、TGs、VCAM-1、LDL-C与颈动脉粥样硬化有相关性。结论在2型糖尿病患者中血清sVCAM-1水平与颈动脉粥样硬化程度相关。sVCAM-1水平可能为2型糖尿病患者大血管病变的标志物,及早检测血清中sVCAM-1浓度可以预测糖尿病大血管病变的发生与发展。
Objective To discuss the multiple factors affecting earotid arteriosclerosis in type 2 diabetes mellitus. Methods One hundred and ten eases of type 2 diabetes were enrollcd and their arterial wall thickness and local atherosclerosis in the earotid arteries （CAs） were examined by B-mode ultrasonography. According to the result of B-mode ultrasonography, the 110 eases were disparted for four groups： carotid arteries normal; carotid arteries inerassative;stabilized plaque; and unstabilized plaque. The fasting serum insulin, proinsulin, sVCAM-1, HbA1c, CHO, TG, LDL-C, HDL-C, CRP and mieroalbuminuria were determined. The relationship between these factors and the grading of carotid arteriosclerosis was analyzed. Results Insulin, proinsulin, HbA1c, BMI, CRP and mieroalbuminuria showed no signifieant difference among four groups. The levels of CHO, TG, LDL-C, HDL-C and sVCAM-1 were lower in normal group than those in other groups. Multiple linear regression showed that the grade of atherosclerosis correlated with age, TG, LDL-C and sVCAM-1. Conclusion sVCAM-1 level is likely to be a marker of the diabetes＇complieation.
出处
《山西医药杂志》
CAS
2005年第11期914-917,共4页
Shanxi Medical Journal
