CAJ | 학술논문

目的探讨2型糖尿病(DM)患者颈动脉内膜中层厚度(IMT)改变及与各种危险因子的关系.方法对5个年龄组123例DM患者和102例正常人行超声波IMT检测,并对界值上下两组DM患者临床数据进行比较.结果①DM患者与正常人IMT均随年龄增长而增厚,各年龄组DM患者IMT均较正常人明显增厚(P＜0.05～P＜0.01),30岁～、40岁～组DM病人与50岁～、60岁～组正常人IMT相似.②正常人IMT为0.61±0.07mm,其中98%为＜0.8mm;DM患者IMT为0.85±0.21mm,其中56%为≥0.8mm.③DM患者IMT≥0.8mm组的收缩压、舒张压、高血压病程、空腹胰岛素、24小时尿白蛋白、CHD及CVD发生率明显增高,胰岛素敏感指数却明显低于IMT＜0.8mm组(P＜0.05～P＜0.01),而空腹血糖、餐后2小时血糖、2小时胰岛素、HbA1c、胆固醇、甘油三酯两组间无显著性差异.结论 DM患者IMT增厚早、进展快,IMT≥0.8mm的DM患者心脑血管病危险增加.尿白蛋白增加是IMT增厚的标志.高血压、高胰岛素血症、胰岛素抵抗对动脉粥样硬化的促进作用从早期即存在影像学的证据.
목적탐토2형당뇨병(DM)환자경동맥내막중층후도(IMT)개변급여각충위험인자적관계.방법대5개년령조123례DM환자화102례정상인행초성파IMT검측,병대계치상하량조DM환자림상수거진행비교.결과①DM환자여정상인IMT균수년령증장이증후,각년령조DM환자IMT균교정상인명현증후(P＜0.05～P＜0.01),30세～、40세～조DM병인여50세～、60세～조정상인IMT상사.②정상인IMT위0.61±0.07mm,기중98%위＜0.8mm;DM환자IMT위0.85±0.21mm,기중56%위≥0.8mm.③DM환자IMT≥0.8mm조적수축압、서장압、고혈압병정、공복이도소、24소시뇨백단백、CHD급CVD발생솔명현증고,이도소민감지수각명현저우IMT＜0.8mm조(P＜0.05～P＜0.01),이공복혈당、찬후2소시혈당、2소시이도소、HbA1c、담고순、감유삼지량조간무현저성차이.결론 DM환자IMT증후조、진전쾌,IMT≥0.8mm적DM환자심뇌혈관병위험증가.뇨백단백증가시IMT증후적표지.고혈압、고이도소혈증、이도소저항대동맥죽양경화적촉진작용종조기즉존재영상학적증거.
Objective In order to ascertain the change of IMT in patients with type 2 DM and the relationship between IMT and various risk factors.Methods Using B-mode ultrasonography to measure the IMT in 123 diabetics and 102 healthy controls and to compare the clinical data between two DM groupes.Results ① The IMT of both diabetics and controls increased with the age.The IMT of every age group was obviously thicker in diabetics than in controls ( P <0 05～ P <0.01).The IMT of diabetics at the age of 30～ and 40～ was the same as that of 50～ and 60～.②The IMT of controls was 0.61±0.07mm,98% of them was <0.8mm.The IMT of diabetics was 0.85±0.41mm,56% of them was ≥0.8mm.③SBP、DBP、the duration of hypertension,FIns,24h UALB,the percentage of CHD and CVD were apparently higher;ISI was obviously lower in group of IMT≥0.8mm than in group of IMT<0.8mm( P <0 05～ P <0.01).There was no significant difference in the duration of DM,the FBG,2hBG、HbA1c,2hIns,TC and TG between two groups.Conclusion The increase of IMT in type 2 DM develops early and rapidly.The increase of UALB is the marker of the thickened IMT.The chance of CHD and CVD in patients with IMT≥0.8mm is increased.It can be seen that hypertention,hyperinsulinimia and insulin resistance accelarate the AS since carly phase.