摘要
目的 探讨老年 2型糖尿病患者颈动脉硬化以及粥样斑块与各种危险因子的关系。方法 用彩色多普勒超声观察 6 8例老年 2型糖尿病患者双侧颈动脉内中膜厚度 (IMT)。结果 内膜增厚组及斑块形成组空腹胰岛素水平、2 4h尿白蛋白定量明显增加 (P <0 .0 5 ,P <0 .0 1) ,并且随着内膜增厚程度的加重 ,这种增加越明显 ,而胰岛素敏感指数明显降低 (P <0 .0 5 )。空腹、餐后 2h血糖、糖化血红蛋白及餐后 2h胰岛素、血脂各项指标在各组间变化不明显。内膜增厚组及斑块形成组年龄 ,有高血压、冠心病、脑血管病史的百分比 ,高血压病程 ,收缩压 ,舒张压值均有明显增高 (P <0 .0 5 ,P <0 .0 1)。吸烟人数百分比、糖尿病病程无明显差异。结论 老年糖尿病患者IMT增厚者心脑血管疾病的发病率增高 ,这与他们存在高胰岛素血症、低胰岛素敏感性以及有较高的尿白蛋白水平有关 。
Objective To investigate the carotid arteriosclerosis and atherosclerotic plaques in the elderly with type 2 diabetes mellitus (DM) and their relationship with various risk factors.Methods Color Doppler ultrasound was used to measure the intima media thickness (IMT) in 68 elderly patients with type 2 DM.Results The level of fasting insulin (FIns), 24 hour urine albumin (24h UALB), the age, the incidence of coronary heart disease (CHD) and cerebrovascular disease (CVD), systolic blood pressure (SBP), diastolic blood pressure (DBP), the duration of hypertension were apparently higher in the group with thicker IMT and plaque.The thicker the IMT,the higher the above indices(P<0.05,P<0.01). The insulin sensitivity index(ISI) was obviously lower (P<0.05). There was no significant difference in the fasting blood glucose (FBG), 2 hour postprandial blood glucose (2hBG), glycosylated hemoglobin (HbA1c), 2 hour postprandial insulin (2hIns), blood lipids, the smoking and the duration of DM. Conclusions In type 2 DM elderly with thick IMT, the incidences of CHD and CVD are increased. It might be related to the hyperinsulinemia, decreased sensitivity to insulin and increased UALB. IMT may be used as a reference index for the prediction of atherosclerosis in the type 2 DM.
出处
《中华老年多器官疾病杂志》
2003年第1期34-36,共3页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
2型糖尿病
颈动脉粥样硬化
老年人
诊断
治疗
diabetes mellitus,type 2
ultrasound,Doppler
arteries carotid
atherosclerosis
