CAJ | 학술논문

目的超声动态评价强化治疗对初诊2型糖尿病（T2DM）患者亚临床动脉粥样硬化（AS）的价值。方法随访135例T2DM患者3年，根据入组时间分为强化治疗组(75例)和常规治疗组（60例）。观察干预3年后两组患者的代谢控制情况及颈总动脉（CCA）、髂总动脉（CIA）、股总动脉（CFA）内膜-中层厚度（IMT）和AS斑块的变化情况。结果强化治疗组的各动脉内膜-中层增厚率均低于常规治疗组，均有统计学差异（均P＜0.05）。比较两组患者斑块分布情况，干预1年后和2年后强化治疗组股动脉斑块好转率高于常规治疗组（χ2=5.49、8.39，均P＜0.05），其余指标好转率均无统计学差异（均P＞0.05）。结论强化治疗后T2DM患者CCA、CIA及CFA内膜-中层增厚明显减少，但对血管内已形成的AS斑块改善不明显。高频超声可作为首选观察随访手段。
목적초성동태평개강화치료대초진2형당뇨병（T2DM）환자아림상동맥죽양경화（AS）적개치。방법수방135례T2DM환자3년，근거입조시간분위강화치료조(75례)화상규치료조（60례）。관찰간예3년후량조환자적대사공제정황급경총동맥（CCA）、가총동맥（CIA）、고총동맥（CFA）내막-중층후도（IMT）화AS반괴적변화정황。결과강화치료조적각동맥내막-중층증후솔균저우상규치료조，균유통계학차이（균P＜0.05）。비교량조환자반괴분포정황，간예1년후화2년후강화치료조고동맥반괴호전솔고우상규치료조（χ2=5.49、8.39，균P＜0.05），기여지표호전솔균무통계학차이（균P＞0.05）。결론강화치료후T2DM환자CCA、CIA급CFA내막-중층증후명현감소，단대혈관내이형성적AS반괴개선불명현。고빈초성가작위수선관찰수방수단。
Objective To investigate the efficacy of intensive treatment on subclinical atherosclerosis evaluated by high resolution ultrasonography (US) in patients with newly diagnosed type 2 diabetes mel itus (T2DM). Methods One hundred and thirty five incipient T2DM patients were al ocated into two groups and fol owed for 3 years:75 cases received intensive treatment and 60 cases received conventional treatment. Noninvasive high resolution B mode ultrasonography was used to measure the in-tima- medial thickness (IMT) and atherosclerotic plaques of common carotid artery (CCA), common iliac artery (CIA) and common femoral artery (CFA) in al subjects. Dynamic changes in al metabolic indicators were measured. Results The increased IMT rates of CCA, CIA and CFA in intensive treatment group was lower than that in conventional treatment group (P<0.05). The im-provement rate of CFA plaque in intensive therapy group was higher than that in conventional treatment group 1 and 2 years after treatment (χ2=5.49, P<0.05 and χ2=8.39, P<0.05, respectively). There were no significant differences in remaining indicators be-tween two groups. Conclusion Intensive treatment can control IMT of arteries, but not atherosclerotic plaques in T2DM patients. High- frequency ultrasonography can be used as effective means for fol ow- up observation.