2型糖尿病患者下肢动脉内膜中层厚度与超敏C反应蛋白及纤维蛋白原的相关性分析

摘要

目的：探讨2型糖尿病（T2DM）患者下肢动脉内膜中层厚度（IMT）与超敏C反应蛋白（hs-CRP）及纤维蛋白原（Fg）的相关性。方法选取2010年1-12月在暨南大学第二临床学院内分泌科住院的T2DM患者89例作为T2DM组，选取同期体检中心的健康者85例作为对照组。收集临床资料〔包括年龄、性别、身高、血压（收缩压和舒张压）、腰围、臀围，计算体质指数（ BMI）和腰臀比（ WHR）〕；检测生化指标〔包括空腹血糖（ FPG）、糖化血红蛋白（HbA1c）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（ HDL-C）、hs-CRP、Fg〕；彩超测量下肢动脉〔股动脉（ CFA）及腘动脉（ POA）〕IMT。采用Pearson线性相关分析下肢动脉IMT与hs-CRP及Fg的关系。结果两组收缩压和舒张压比较，差异无统计学意义（ P>0.05）；T2DM组患者的BMI和WHR均高于对照组（P<0.05）。两组TG、TC比较，差异无统计学意义（P>0.05）；T2DM组患者的LDL-C、FPG、HbA1c均高于对照组，而HDL-C低于对照组（ P<0.05）。T2DM组的hs-CRP、Fg、CFA IMT、POA IMT均高于对照组（P <0.05）。T2DM 组患者 CFA IMT与 POA IMT 呈正相关（r =0.461，P <0.05），CFA IMT 与hs-CRP、Fg呈正相关（r=0.367、0.456，P <0.05），POA IMT与hs-CRP、Fg 呈正相关（r =0.379、0.417，P <0.05）。结论 T2DM患者下肢动脉IMT与hs-CRP及 Fg 均呈正相关关系，动态监测hs-CRP及 Fg 有助于早期预测T2DM下肢动脉病变的发生发展，值得临床推广应用。%Objective To assess the association between peripheral arterial intima-media thickness and high sensitive C-reactive protein,fibrinogen in T2DM. Methods From January to December 2010,89 T2DM patients(T2DM group)hos-pitalized in department of endocrinology,the Second Affiliated Hospital of Jinan University and 85 healthy subjects( control group)were enrolled in this study. The clinical data were collected,FPG,HbA1c,TG,TC,LDL-C,HDL-C,hs-CRP, Fg determined,IMT of CFA and POA measured by color doppler ultrasound. The relationship of IMT with hs-CRP and Fg was analyzed by Pearson linear regression analysis. Results There was no significant difference in SBP,DBP between 2 groups( P>0. 05). BMI and WHR were higher in T2DM group than in control group(P<0. 05). There was no difference in TG,TC between 2 groups(P>0. 05). LDL-C,FPG,HbA1c were higher in T2DM group than in control group,but HDL-C lower (P<0. 05). The levels of hs-CRP,Fg,CFA IMT,POA IMT were higher in T2DM group than in control group(P<0. 05). CFA IMT was positively correlated with POA IMT(r=0. 461,P<0. 05),CFA IMT positively with hs-CRP,Fg(r=0. 367, 0. 456,P<0. 05),POA IMT positively with hs-CRP,Fg(r=0. 379,0. 417,P<0. 05). Conclusion Lower extremity arterial IMT is positively correlated with hs-CRP,Fg in T2DM patients. Dynamic monitoring of hs-CRP,Fg contributes to early prediction of the development of lower extremity arterial diseases,worthy of clinical application.