摘要
目的探讨强化控制对2型糖尿病(T2DM)患者颈动脉内膜中层厚度(IMT)的影响。方法选取140例无血管并发症及血脂异常的初发T2DM患者,随机分为两组。A组64例,给予强化降糖+降压治疗;B组76例,给予强化降糖+降压+他汀类药物治疗。随诊12个月,检测治疗前后患者颈动脉IMT的变化及其代谢控制情况。结果①强化控制12个月后,A组患者颈动脉IMT较治疗前有所增厚(P<0.01),B组患者颈动脉IMT与治疗前相比无明显改变,但与A组治疗后相比,差异具有统计学意义(P<0.01);②B组患者TC及LDL-C水平较治疗前明显下降,并显著低于A组(P<0.01);③COX回归分析显示,舒张压升高、HDL-C降低和有高血压家族史均是T2DM患者劲动脉IMT增厚的危险因素。结论在强化降糖、降压基础上加用他汀类药物治疗,更有利于减少初发T2DM患者动脉粥样硬化的发生,对防治糖尿病血管病变有一定的积极意义。
【Objective】To investigate the effects of intensive treatment on carotid artery intima-media thickness（IMT） in type 2 diabetic patients.【Methods】One hundred and forty newly diagnosed type 2 diabetic patients without vascular complication or dyslipidemia were randomly divided into two groups.Sixty-four patients in group A were treated with intensive control of blood glucose and blood pressure.Seventy-six patients in group B were treated with intensive control of blood glucose and blood pressure and medication of statins.In the follow-up of twelve months,IMT was determined by duplex ultrasonography and the status of metabolic control was detected before and after the therapy.【Results】After intensive treatment for twelve months,the IMT of diabetic patients in group A increased compared to that before treatment（P0.05）.The IMT of diabetic patients in group B had no obvious change compared with that before treatment.However,the IMT after treatment in both groups were significant different（P0.05）.Serum TC and LDL-C levels in diabetic patients of group B were significantly decreased as compared with those before treatment,and lower than those in group A（P0.05）.With COX regression analysis,raised diastolic blood pressure,reduced HDL-C level and the family history of hypertension were all predictive factors of carotid artery intima-media thickening in type 2 diabetic patients.【Conclusion】Addition of statins treatment to intensive blood glucose and blood pressure interventions is more effective to reduce the incidence of atherosclerosis in newly diagnosed type 2 diabetic patients.It has positive significance to prevention of diabetic angiopathies.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第2期241-243,共3页
China Journal of Modern Medicine
关键词
糖尿病
2型
颈动脉内膜中层厚度
diabetes mellitus
type 2
carotid artery intima-media thickness
