CAJ | 학술논문

目的探讨老年2型糖尿病与动脉粥样硬化的关系.方法对2005年4月至2007年10月住院的277例大于60岁的老年患者的临床资料进行回顾性分析,将其分为糖尿病伴颈动脉粥样硬化组(A组119例)、糖尿病不伴颈动脉粥样硬化组(B组30例)、非糖尿病伴颈动脉粥样硬化组(C组32例)和非糖尿病不伴颈动脉粥样硬化组(D组96例),分析颈动脉斑块与各因素的相关性.结果 ①A组与C组比较显示空腹血糖[(7.14±2.49)mmoL/L与(5.21±0.87mmol/L)],TG[(1.41±0.78)mmol/L与(0.95±0.39)mmol/L],左、右颈动脉内膜-中层厚度[(0.85±0.11)mm与(0.79±0.08)mm,(0.85±0.11)mm与(0.78±0.09)mm]、斑块指数(1.37±1.16与0.50±0.80)明显增高(P均<0.01),HDL-C[(1.29±0.32)mmol/L与(1.58±0.45)mmol/L]明显降低(P<0.01);②A组与B组比较显示左、右颈动脉内膜-中层厚度[(0.85±0.11)mm与(0.80±0.11)mm,(0.85±0.11)mm与(0.80±0.12)mm]、斑块指数(1.37±1.16与0.00±0.00)及脑卒中发病率[34.5%(41/119)与13.3%(4/30)]明显增高(P<0.05或P<0.01);③颈动脉斑块与糖尿病史(r=0.551,P<0.01)、高血压病史(r=0.169,P<0.01)、冠心病史(r=0.109,P<0.05)、脑卒中史(r=0.136,P<0.05)、脂肪肝(r=0.340,P<0.01)、FBG(r=0.339,P<0.01)、TG(r=0.195,P<0.01)、ApoB(r=0.152,P<0.05)呈直线正相关,与HDL-C(r=-0.143,P<0.05)呈直线负相关.结论老年2型糖尿病患者发生动脉粥样硬化的危险性高于非糖尿病患者,伴有动脉粥样硬化的糖尿病患者脑卒中发病率高于不伴动脉粥样硬化的糖尿病患者,颈动脉斑块的发生与糖尿病史、高血压病史、冠心病史、脑卒中史、脂肪肝、FBG、TG、ApoB呈正相关,与HDL-C呈负相关.
목적 탐토노년2형당뇨병여동맥죽양경화적관계.방법 대2005년4월지2007년10월주원적277례대우60세적노년환자적림상자료진행회고성분석,장기분위당뇨병반경동맥죽양경화조(A조119례)、당뇨병불반경동맥죽양경화조(B조30례)、비당뇨병반경동맥죽양경화조(C조32례)화비당뇨병불반경동맥죽양경화조(D조96례),분석경동맥반괴여각인소적상관성.결과 ①A조여C조비교현시공복혈당[(7.14±2.49)mmoL/L여(5.21±0.87mmol/L)],TG[(1.41±0.78)mmol/L여(0.95±0.39)mmol/L],좌、우경동맥내막-중층후도[(0.85±0.11)mm여(0.79±0.08)mm,(0.85±0.11)mm여(0.78±0.09)mm]、반괴지수(1.37±1.16여0.50±0.80)명현증고(P균<0.01),HDL-C[(1.29±0.32)mmol/L여(1.58±0.45)mmol/L]명현강저(P<0.01);②A조여B조비교현시좌、우경동맥내막-중층후도[(0.85±0.11)mm여(0.80±0.11)mm,(0.85±0.11)mm여(0.80±0.12)mm]、반괴지수(1.37±1.16여0.00±0.00)급뇌졸중발병솔[34.5%(41/119)여13.3%(4/30)]명현증고(P<0.05혹P<0.01);③경동맥반괴여당뇨병사(r=0.551,P<0.01)、고혈압병사(r=0.169,P<0.01)、관심병사(r=0.109,P<0.05)、뇌졸중사(r=0.136,P<0.05)、지방간(r=0.340,P<0.01)、FBG(r=0.339,P<0.01)、TG(r=0.195,P<0.01)、ApoB(r=0.152,P<0.05)정직선정상관,여HDL-C(r=-0.143,P<0.05)정직선부상관.결론노년2형당뇨병환자발생동맥죽양경화적위험성고우비당뇨병환자,반유동맥죽양경화적당뇨병환자뇌졸중발병솔고우불반동맥죽양경화적당뇨병환자,경동맥반괴적발생여당뇨병사、고혈압병사、관심병사、뇌졸중사、지방간、FBG、TG、ApoB정정상관,여HDL-C정부상관.
Objective To investigate the relationship between type-2 diabetes mellitus and artery atherosclerosis(AS) in the elderly. Methods The clinical data of 277 elders,who were admitted in hospital between April 2005 and September 2007, were retrospectively analyzed. These elders were divided into four groups: type 2 diabetes with carotid atherosclerosis (CAS) group (group A, n=119), type 2 diabetes without CAS group (group B, n= 30), non-diabetic with CAS group (group C, n=32), non-diabetic without CAS group (group D, n=96). The correlation between carotid artery plaque and related factors were studied. Results ① Compared with group C,fasting blood glucose[(7.14±2.49) mmol/L vs. (5.21±0.87) mmol/L], triglycefide [(1.41±0.78) mmol/L vs. (0.95±0.39) mmol/L],left and right common carotid artery IMT [(0.85±0.11) nun vs. (0.79±0.08) mm, (0.85±0.11)mm vs. (0.78±0.09)mm] and PI [(1.37±1.16) vs. (0.50±0.80)] of group A were significantly increased, while high density lipoprotein [(1.29±0.32) mmol/L vs. (1.58±0.45) mmol/L] is significantly decreased(P=0.01). ②Compared with group B, left and right common carotid artery IMT [(0.85±0.11) mm vs. (0.80±0.11)mm,(0.85±0.11)mm vs. (0.80±0.12)mm,PI[(1.37±1.16) vs. (0.00±0.00)]and incidence of stroke 34.5% (41/119) vs. 13.3% (4/30) of group A are significantly increased (P<0.05 or P<0.01). ③Carotid artery plaque was positively correlated with history of diabetes(r=0.051, P<0.01),hypertension(r= 0.169,P<0.01),coronary heart disease (r=0.109,P<0.05),stroke(r=0.136,P<0.05),fatty liver(r= 0.340,P<0.01),FBG(r=0.339,P<0.01),TG(r=0.195,P<0.01),APOB (r=0.152,P<0.05),but negatively correlated with HDL-C (r=-0.143, P<0.05). Conclusion The risk of AS is higher in elderly patients with type 2 diabetes than that of non-diabetes. The incidence of stroke is higher in type 2 diabetes with AS than those of type 2 diabetes without AS. Carotid artery plaque is positively correlated with diabetes, hypertension, history of coronary heart disease, history of stroke, fatty liver, FBG, TG, ApoB, but negatively correlated with HDL-C.