CAJ | 학술논문

目的：研究缺血性卒中合并2型糖尿病（type 2 diabetes mellitus ，T2DM ）患者的颈动脉斑块的临床特点和影响因素。方法：将2013年7月-12月收治的185例缺血性卒中患者分为T2DM组（n＝72）及非 T2DM 组（n＝113），用超声检查颈动脉斑块，其中22例患者行颈动脉CT血管造影（computed tomographic arteriography ，CTA）检查；分析糖、脂代谢相关指标与颈动脉斑块大小的相关性。结果：T2DM 组颈动脉斑块的发生率、性质、大小及颈动脉内中膜厚度（intima-media thickness ， IM T ）与非T2DM组比较差异有统计学意义（P＜0．05）。影响颈动脉斑块大小的主要因素为是否患T2DM 、餐后2 h血糖（2 h postprandial blood glucose ，2 h PBG）、稳态模型胰岛素抵抗指数（homeostatic model assessment for insulin resistance ，HOMA-IR）、空腹血糖（fasting blood glucose ，FBG）、低密度脂蛋白胆固醇（low density lipoprotein-cholesterol ，LDL-C），P＜0．05。超声和CTA对22例患者颈动脉管腔的狭窄程度的检查结果差异有统计学意义（P＜0．05）。结论：缺血性卒中患者颈动脉斑块的大小与是否患T2DM、2 h PBG、HOM A-IR、FBG和LDL-C相关，合并 T2DM 时颈动脉斑块发生率升高，易损斑块比例升高。超声检查可作为颈动脉斑块筛查的首选方法，CTA更易于显示斑块的性质及管腔的狭窄程度。
목적：연구결혈성졸중합병2형당뇨병（type 2 diabetes mellitus ，T2DM ）환자적경동맥반괴적림상특점화영향인소。방법：장2013년7월-12월수치적185례결혈성졸중환자분위T2DM조（n＝72）급비 T2DM 조（n＝113），용초성검사경동맥반괴，기중22례환자행경동맥CT혈관조영（computed tomographic arteriography ，CTA）검사；분석당、지대사상관지표여경동맥반괴대소적상관성。결과：T2DM 조경동맥반괴적발생솔、성질、대소급경동맥내중막후도（intima-media thickness ， IM T ）여비T2DM조비교차이유통계학의의（P＜0．05）。영향경동맥반괴대소적주요인소위시부환T2DM 、찬후2 h혈당（2 h postprandial blood glucose ，2 h PBG）、은태모형이도소저항지수（homeostatic model assessment for insulin resistance ，HOMA-IR）、공복혈당（fasting blood glucose ，FBG）、저밀도지단백담고순（low density lipoprotein-cholesterol ，LDL-C），P＜0．05。초성화CTA대22례환자경동맥관강적협착정도적검사결과차이유통계학의의（P＜0．05）。결론：결혈성졸중환자경동맥반괴적대소여시부환T2DM、2 h PBG、HOM A-IR、FBG화LDL-C상관，합병 T2DM 시경동맥반괴발생솔승고，역손반괴비례승고。초성검사가작위경동맥반괴사사적수선방법，CTA경역우현시반괴적성질급관강적협착정도。
Objective:To study the clinical characteristics and risk factors of carotid artery plaques in patients with type 2 dia-betes mellitus(T2DM ) and ischemic stroke .Methods :A total of 185 patients with ischemic stroke from Jul 2013 to Dec 2013 were divided into T2DM group(n=72) and non-T2DM group(n=113) .All the patients underwent ultrasonic examination to confirm the incidence of carotid artery plaques .And 22 patients received computed tomographic arteriography (CTA) for further diagnosis of carotid artery plaques .The relationships of glucose metabolism and lipid metabolism with the size of carotid artery plaquewereanalyzed.Results:Theincidencerate,natureandsizeofcarotidarteryplaque,intima-mediathickness(IMT)ofca-rotid artery in T2DM group were significantly different from those in non-T2DM group(P<0 .05) .The main factors affecting the sizes of carotid artery plaques were T 2DM ,2 h postprandial blood glucose(2 h PBG) ,homeostatic model assessment for in-sulin resistance(HOMA-IR) ,fasting blood glucose(FBG) ,low density lipoprotein-cholesterol(LDL-C) , P<0 .05 .There was significant difference in the degree of lumen stenosis detected by ultrasound and CTA in the 22 patients(P<0 .05) .Conclu-sions:The size of carotid artery plaque in patients with ischemic stroke are influenced by T 2DM ,2 h PBG ,HOMA-IR ,FBG and LDL-C .The incidences of plaques as well as vulnerable plaques increases when patients suffer with T 2DM simultaneously .Ul-trasound can be applied as the preferred method for carotid artery plaque screening .CTA manifests as a more promising manner to demonstrate the characteristics of the plaques and the severity of lumen stenosis .