老年糖尿病患者血糖及糖化血红蛋白与颈动脉粥样硬化斑块的关系

摘要

Objective To understand the relationships between blood glucose,HbA1 c and the carotid artery atherosclerotie plaques in elders with type 2 diabetes. Methods A total of 101 male patients with type 2 diabetes aged 60-89 were chosen. The fasting blood glucose, 1hr post-prandial blood glucose and 2hr post-prandial blood glucose and HbA1c were tested in all the patients. The intima-media thickness (IMT) of the common carotid artery, thickness and diameter of the common and the internal carotid artery atherosclerotic plaques were measured by color doppler ultrasonography, the numbers of atherosclerotic plaques, characteristics and locations were also recorded. Results Among 55 patients with P2hBG less than l0mmol/L,12 patients had a score higher than 3 on atherosclerotic plaques, which took up to 21.8％. Of 46 cases run out of the limitation, and there were 21 cases (45.7％) with atherosclerofic plaque score higher than 3, and the difference showed statistical significance with P ＜ 0. 05. Among the 54 patients with HbA1c level less than 6.5％, 11 patients had the scores higher than 3 on atherosclerotic plaques, which took up to 20.4％. However,there were 16 patients with the atherosclerotic plaque scores higher than 3 ,which took up to 45.7％ of the 35 patients with HbA1c ＞ 6.5％, and the difference also showed statistical significance with P ＜ 0.05. Logistic regression analysis showed that P2hBG and HbA1 c were independent factors influencing the carotid artery atherosclerotic plaques. Conclusion Increased P2hBG and HbA1 c is associated with the formation of atheroaclerotic plaques in old patients with type 2 diabeties.%目的 了解老年2型糖尿病患者血糖及糖化血红蛋白(HbA1c)与颈动脉粥样硬化斑块严重程度的关系.方法 101例老年2型糖尿病男性患者,测定其空腹、餐后1h、2h血糖及HbA1c.颈动脉测定用彩色多普勒超声诊断仪,检测患者双侧颈总动脉内膜中层厚度(IMT)及颈总动脉、颈内动脉粥样硬化斑块的厚度、直径,同时记录斑块数量、性质和部位.结果 (1)餐后2h血搪达标者55例,颈动脉斑块3分以上12例,占21.8%,未达标者46例,颈动脉斑块3分以上21例,占45.7%,两者相比差异有统计学意义(X2x6.469,P<0.05);(2)HbA1c达标者54例,颈动脉斑块3分以上11例,占20.4%,未达标者35例,颈动脉斑块3分以上16例,占45.7%,两者相比有差异(X(2)=6.454,P<0.05);(3)Logistic多元回归方程分析,餐后2h血糖及HbA1c与颈动脉粥样硬化斑块关系密切相关(P<0.05).结论:餐后2h血糖和HbA1c升高是颈动脉粥样硬化斑块危险因素.