摘要
目的研究2型糖尿病(DM)大血管病变(MA)的特点、相关危险因素及临床意义。方法将316例2型DM患者分为有MA组174例,其中缺血性心脏病(IHD)患者80例、脑血管病变(CVD)患者55例、周围血管病变(PVD)患者64例;非MA组142例。所有患者均做口服糖耐量试验(OGTT)、胰岛素释放试验,检测空腹血糖(FPG)、2小时血糖(2h PG)、空腹血清胰岛素(FINS)水平,根据结果计算胰岛素抵抗指数(HOMA-IR);检测瘦素(LEP)、白介素-6(IL-6)、C反应蛋白(CRP)等,对2型DM大血管病变的临床数据进行比较及回归分析。结果(1)MA组的年龄、高血压患病率与非MA组比较有显著性差异(P<0.01);(2)MA组IL-6、CRP与非MA组比较有显著性差异(P<0.05,P<0.01),MA组LEP与非MA组比较无显著性差异(P>0.05);(3)回归分析显示,高血压、年龄是2型DM病患者MA的独立危险因素(P<0.01)。结论年龄、高血压是2型DM患者发生MA的独立危险因素;2型DM合并MA者存在低水平慢性炎症;积极控制血压可能对减少其大血管事件的发生有重要意义。
Objective To study the characteristic features of risk factors for macrovascular disease （MA）in patients with type 2 diabe- tes. Methods 316 cases of type 2 diabetes were divided into 2 groups：174 cases with MA, including 80 with ischernic heart disease（IHD）,55 with cerebrovaseular disease（CVD）, 64 with peripheral vascular disease（PVD）. 142 cases was without macrovascular dlsease（M/k）.The experimental group were taken the oral glucose tolerance test（OGTT） and insulin releasing test, FPG, 2hPG, FINS were detected. According to the results Homa - IR was calculated. Leptin（LEP）, intenleukiu - 6（ IL- 6）, C - reaction protein（CRP） and albtnnin/creatinine ratio（A/C） were also tested, All clinical data were compared and logistic regresaion analysis was used to reveal the risk factors for MA. Results The old age , hypertension were significantly increased in patients with MA compared with patients without MA（ P 〈0.01）. （2） The IL- 6, CRP and A/C were all higher than that in patients with MA compared with patients without MA（ P 〈 0.05, P 〈 0.01 ）. LEP were alike than that in patients with MA compared with patients without MA（P〉0.05）. （3）With stepwise multivar/ate logistic regression analysis, old age and hypertension were identified as significant and independent risk factors for MA（ P 〈 0.01 ）. Conclusion In T2DM patients, the older age and hypertension are found to be risk factors for MA. There may be a chromic inflammatory reaction in patients with type 2 diabetes with macrovascular disease. It seem to be crucial to give them tight blood pressure control for the prevention of MA in T2DM patients.
出处
《宁夏医学杂志》
CAS
2006年第1期20-22,共3页
Ningxia Medical Journal
基金
宁夏银川市科技攻关项目(2004-36)
