糖尿病患者颈动脉斑块特征与吸烟的相关性分析

摘要

Objective To explore the correlation between carotid plaque characteristics and smoking in patients with diabetics.Methods From July 2015 to May 2017,275 patients with diabetics in the endocrinology clinic of Deqing Traditional Chinese Medicine Hospital were selected as the research objects and divided into the smoking group (150 cases)and the non-smoking group (125 cases).Carotid doppler ultrasound examination was performed for all patients.The clinical data,characteristics of carotid plaque and the hemodynamic indicators [peak systolic velocity (PSV),end-diastolic velocity (EDV),pulse index (PI),resistance index (RI) and PSV/EDV] between the two groups were analyzed.The correlation between carotid plaque and smoking was analyzed.Results The maximum thickness,number,echo,carotid artery stenosis rate and hemodynamic parameters of PSV,EDV,PI,RI and PSV/EDV in the non-smoking group were better than those of smoking group,with statistically significant differences (P ＜ 0.05).The patch echo,PSV/EDV and the maximum thickness of plaque had high diagnostic value in diabetes,and the area under the curve was 0.877,0.875 and 0.841.In smoking groups,the total amount of smoking had no effect on the stability of carotid plaque (P ＞ 0.05).Conclusion There is a close correlation between carotid plaque characteristics and smoking in patients with diabetics.Carotid doppler ultrasound examination can be a valuable tool for screening high-risk population of diabetes.It is an important guiding role in early diagnosis and treatment of carotid atherosclerotic disease.%目的 探讨糖尿病患者颈动脉斑块特征与吸烟的相关性.方法 选择2015年7月～2017年5月在德清县中医院内分泌门诊就诊的糖尿病患者275例作为研究对象,按照是否吸烟分为吸烟组(150例)和未吸烟组(125例),均经颈动脉多普勒超声检查,分析两组患者的临床资料、颈动脉斑块的特征和血流动力学指标[包括收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、搏动指数(PI)、阻力指数(RI)和PSV/EDV],分析糖尿病患者颈动脉斑块与吸烟的相关性.结果 未吸烟组颈动脉斑块的最大厚度、数目、回声、颈动脉内径狭窄率及血流动力学参数PSV、EDV、PI、RI和PSV/EDV均优于吸烟组,差异均有统计学意义(P＜0.05).斑块回声、PSV/EDV、斑块最大厚度等对糖尿病诊断具有较高的诊断价值,曲线下面积依次为0.877、0.875、0.841.吸烟组患者中,不同吸烟总量对颈动脉斑块的稳定性比较,差异无统计学意义(P＞0.05).结论 糖尿病患者颈动脉斑块的特征与吸烟有着密切的相关性,颈部血管超声可成为糖尿病高危人群筛查有价值的手段,对早期诊断及治疗颈动脉粥样硬化性疾病具有重要的指导作用.