2型糖尿病非增生型视网膜病变与颈动脉内膜中层厚度的关系

摘要

Objective To explore the relationship between non-proliferative diabetic retinopathy and the carotid artery intima-media thickness(IMT) in type 2 diabetic patients.Methods 197 patients with type 2 diabetes mellitus were divided into two groups, 97 patients with non-proliferative diabetic retinopathy (NPDR) and 100 patients without diabetic retinopthy (NDR).Intima-media thickness was measured using B mode ultrasonography.Results (1) IMT was significantly higher in patients with NPDR than in patients without DR( P＜0.01); (2)NPDR was positively correlated with age, the course of disease, systolic blood pressure, diastolic blood pressure, glycosylated hemoglobin, IMT, urinary microalbumin (P＜0.05) and was negatively correlated with high density lipoprotein-cholesterol, 2h C-Peptide(P＜0.05).Logistic regression analysis showed that IMT was the most important risk factor for NPDR (P＜0.01);(3)In diabetic patients, the prevalence of diabetic retinopathy was higher in thickened IMT group(60.7％) than in normal IMT group(44.1％) (P＜0.05).Conclusions The morbidity of NPDR is higher in type 2 diabetic patients complicated with thickened IMT, speculating that atherosclerosis may be a critical relative factor of NPDR.%目的 探讨2型糖尿病(T2DM)患者非增生型视网膜病变(NPDR)与颈动脉内膜中层厚度(IMT)之间的关系.方法 选择NPDR组97例,糖尿病正常眼底(NDR)对组照100例.B超检测IMT.结果 (1)NPDR组IMT明显高于NDR组(P<0.01).(2)NPDR与年龄、病程、收缩压、舒张压、糖化血红蛋白、IMT、尿白蛋白呈正相关(P<0.05),与HDL-C、餐后2h C肽呈负相关(P<0.05).Logistic回归显示IMT是NPDR的主要危险因素(P<0.01).(3)IMT增厚组(60.7%) NPDR发病率明显高于正常组(44.1%)(P<0.05).结论 T2DM合并颈动脉IMT增厚者NPDR发病率显著增高,推测动脉粥样硬化可能是NPDR的一个重要的相关因素.