2型糖尿病患者颈动脉粥样硬化危险因素分析

摘要

目的探讨2型糖尿病患者颈动脉粥样硬化危险因素。方法选择332例住院的2型糖尿病患者行颈动脉动脉多普勒超声检查，并记录患者的一般临床资料、并发症及合并症情况。根据血管彩色多普勒超声结果分为无病变组和有病变组对两组进行比较。采用Logistic回归模型分析颈动脉粥样硬化与各因素的相关性。结果（1）2型糖尿病患者颈动脉患病率分别为71．63％（202／282）。（2）动脉粥样硬化组年龄、病程、纤维蛋白原、高血压患病率、冠心病患病率、脑梗死患病率、糖尿病外周神经病变（DPN ）、糖尿病肾病、糖尿病视网膜病变、糖尿病足发生率与无病变组比较，差异有统计学意义（P＜0．05）。动脉粥样硬化组三酰甘油水平低于无病变组。（3）Logistc分析显示糖尿病病程＞10年，年龄＞60岁是颈动脉粥样硬化危险因素；SBP升高、并发DPN是颈动脉粥样硬化的独立危险因素。结论2型糖尿病患者外周动脉粥样硬化患病率极高，随着年龄的增长和病程的延长患病率逐年递增，2型糖尿病动脉粥样硬化病变与多种危险因素相关。%Objective To explore the risk factors of carotid artery atherosclerosis in type 2 diabetics.Methods A total of 332 patients with type 2 diabete were selected from department of endocrinology,All patients were inspected by the colored Doppler supersonic and divided into carotid artery atherosclerosis(CAS)and normal carotid artery group (N-CAS)according to the results of carotid artery ultrasound.,The general clinical data,complications and accompan-ying diseases were recorded..The risk factors of arterial atherosclerosis were analyzed by Logistic regressive model.Re-sults (1)The prevalence of carotid artery atherosclerosis was 71.63%(202/282)in 282 type 2 diabetics.(2)In CAS group,the age,duration of diabetes,systolic blood pressure(SBP),fibrinogen(FIB),hypertension,coronary heart dis-ease,cerebral infarction,diabetic peripheral neuropathy (DPN ),diabetic nephropathy (DN )and diabetic retinopathy (DR)were significantly(P<0.05)as compared with N-CAS group.(3)The Logistic regression analysis showed that dia-betic duration≥10 years,age≥60 years were the risk factors of carotid artery atherosclerosis,and SBP,DPN were inde-pendent risk factors of carotid artery atherosclerosis.Conclusion The prevalence of atherosclerosis is higher in type 2 diabetes.There is a clear relativity between carotid artery atherosclerosis type 2 diabetes and a number of risk factors.