2型糖尿病颈部及下肢血管病变相关因素分析

摘要

目的:探讨颈部血管病变及下肢血管病变与2型糖尿病病程、年龄及各生化指标的关系.方法:选择2型糖尿病患者130例,根据超声显像仪检测双侧颈动脉及双下肢动脉结果将研究对象分为:A组无下肢动脉和颈动脉斑块形成组44例,B组颈部和或下肢动脉斑块形成组86例.B组根据斑块形成部位进一步分为:B1组颈部动脉斑块形成组66例;B2组下肢动脉斑块形成组84例.测定三组患者血清胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HLDL)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)及尿微量白蛋白(mAIb).同时记录病程、年龄及是否并发高血压、冠心病、脑血管病.结果:①颈部和或下肢动脉斑块形成发生率高达66.2%.②B组病程、年龄、高血压患病率均高于A组.③B组TG高于A组(P＜0.05);TC、HDL-C、LDL-C、尿微量白蛋白(MAU)、HbA1c无显著性差异(P＞0.05).④下肢血管病变发生年龄轻、病程短,B2与B1比较年龄、病程均有显著性差异(P＜0.05);高血压发生率无显著性差异(P＞0.05).⑤B1、B2组冠心病、脑血管病、高血压患病率均高于A组(P＜0.05).且B1组脑血管病患病率高于B2组(P＜0.05).⑥血管病变相关危险因素Logistic回归分析:年龄、病程、高血压史、高TG是血管病变发病的危险因素.结论:2型糖尿病颈部和(或)下肢动脉斑块形成发生率高,年龄、病程、高血压史、高TG是其发生的危险因素.随年龄、病程的增加及并发高血压,其发生率也增加.%Objective : To study the relationship between the macrovascular disease and the course of type 2 diabetes, age and various biochemical indicators , and then provide a theoretical basis for the prevention of macro -vascular disease of type 2 diabetes . Methods :Selected 130 patients with type 2 diabetes .According to the atherosclerotic plaque formation , the subjects were divided into 44 cases in Group A of no formation of lower extremity arteries and carotid artery plaques , and 86 cases in Group B of formation of lower extremity arteries and carotid artery plaques . The Group B could be further divided into according to the plaque site : B1 group, B2 group. In B1 group, there are 66 cases of formation of carotid artery plaques ; in B2 Group, there were 84 cases of formation of lower extremity arteries plaques . Determine serum cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HLDL), fasting blood glucose (FBG), glycated hemoglobin (HbAlc) and urinary albumin (MAU) . At the same time recorded course of the disease , age and whether combine with hypertension . Results :① The occurrence of the formation of lower extremity arteries and carotid artery plaques was as high as 66 .2% . ② The course of disease, age, and the prevalence rate of hypertension in group B were higher than those in group A . ③TG in group B was higher than that of group A (P<0 .05) ;there was no significant difference in the TC , HDL-C and LDL-C , mAIb, HbAic between the two groups (P＞0.05) . ④ Lower extremity vascular lesions occurred in the younger patients , with short course of disease . There was significant difference in the age and course of disease between Group B2 and Groups B1 (P<0 .05) ;while no significant difference in the prevalence rate of hypertension between them (P> 0 .05) . There was no significant difference in the age , course of disease and prevalence rate of hypertension between Group B1 (P>0 .05) . ⑤ The prevalence rate of coronary artery disease , cerebrovascular disease, hypertension in the groups B1 , and those in group B1 with the formation of neck vascular plaques respectively ; and the prevalence rate of cerebrovascular disease was higher than that of group B 2 with the formation of lower extremity arteries plaques ( P<0 .05). ⑥The Logistic regression analysis of the related risk factors of macrovascular disease showed that, the age, course of disease, history of hypertension, high TG were the risk factors for the incidence of macrovascular diseases .Conclusion :The incidence of macrovascular disease of type 2 diabetes is higher , and the age, course of disease, history of hypertension, high TG are the risk factors for it .With increasing of age ,course of disease and hypertension ,it's incidence has also increased .