CAJ | 학술논문

目的比较不同糖代谢异常患者颅内外动脉粥样硬化狭窄的患病率,探讨糖代谢异常相关性脑血管狭窄的早期防治方法. 方法收集自2011年12月至2012年11月在广州中医药大学中山附属医院内分泌科及健康体检中心就诊的糖代谢异常患者及健康体检者635例,分为糖尿病前期组132例(包括空腹血糖异常及糖耐量异常)、糖尿病组268例及健康对照组235例.登记3组对象的相关危险因素并测定血脂、空腹血糖、餐后2h血糖、空腹胰岛素水平,进行颈部血管彩色多普勒、经颅血管彩色多普勒检查并比较3组对象颅内外血管狭窄率、单支及多支血管狭窄率以及前后循环血管狭窄率. 结果健康对照组、糖尿病前期组及糖尿病组患者颅内外总的血管狭窄率分别为5.5％(13/235)、7.6％(10/132)及22.4％(60/268),差异有统计学意义(P＜0.05);3组颅外血管狭窄、颅内血管狭窄发病率逐渐增加,差异有统计学意义(P＜0.05);3组颅内血管狭窄率均高于颅外血管狭窄率.3组多支血管狭窄率逐渐增加,差异有统计学意义(P＜0.05);糖尿病前期组及糖尿病组主要表现为多支血管狭窄.3组颅内血管狭窄均表现为前循环狭窄的发病率较高,且发病率逐渐增加,差异有统计学意义(P＜0.05). 结论糖代谢异常导致的脑动脉粥样硬化性狭窄可能从糖尿病前期已开始,应重视早期对血管狭窄的监测及早期治疗.
목적 비교불동당대사이상환자로내외동맥죽양경화협착적환병솔,탐토당대사이상상관성뇌혈관협착적조기방치방법. 방법 수집자2011년12월지2012년11월재엄주중의약대학중산부속의원내분비과급건강체검중심취진적당대사이상환자급건강체검자635례,분위당뇨병전기조132례(포괄공복혈당이상급당내량이상)、당뇨병조268례급건강대조조235례.등기3조대상적상관위험인소병측정혈지、공복혈당、찬후2h혈당、공복이도소수평,진행경부혈관채색다보륵、경로혈관채색다보륵검사병비교3조대상로내외혈관협착솔、단지급다지혈관협착솔이급전후순배혈관협착솔. 결과 건강대조조、당뇨병전기조급당뇨병조환자로내외총적혈관협착솔분별위5.5％(13/235)、7.6％(10/132)급22.4％(60/268),차이유통계학의의(P＜0.05);3조로외혈관협착、로내혈관협착발병솔축점증가,차이유통계학의의(P＜0.05);3조로내혈관협착솔균고우로외혈관협착솔.3조다지혈관협착솔축점증가,차이유통계학의의(P＜0.05);당뇨병전기조급당뇨병조주요표현위다지혈관협착.3조로내혈관협착균표현위전순배협착적발병솔교고,차발병솔축점증가,차이유통계학의의(P＜0.05). 결론 당대사이상도치적뇌동맥죽양경화성협착가능종당뇨병전기이개시,응중시조기대혈관협착적감측급조기치료.
Objective To compare the incidence of intracranial and extracranial artery stenosis between patients with different degrees of dysglycemia,and investigate early curative methods of diabetes-related stenosis.Methods One hundred and thirty two consecutive pre-diabetes patients,268 diabetes and 235 healthy controls,collected in our hospital from December 2011 to November 2012,were enrolled; and risk factors,including blood fat,fasting glucose,2-h glucose and fasting insulin,were recruited and analyzed; neck vascular color Doppler and transcranial vascular color Doppler ultrasounds were performed on these patients and compared the incidences of intracranial and extracranial stenoses,single-and multi-branches,and anterior and posterior circulation vascular stenoses among three groups.Results The incidences of intracranial and extracranial stenoses in the control,pre-diabetes and diabetes groups were 5.5％ (13/235),7.6％ (10/132) and 22.4％ (60/268),respectively,with statistical differences (x2=35.738,P=0.000); the incidences of extracranial stenosis,intracranial stenosis,and intracranial and extracranial stenoses in control,pre-diabetes and diabetes groups increased with significant difference (P＜0.05); the incidence of intracranial stenosis of all groups were higher than that of extracranial stenosis.The incidence of multi-branches stenosis in the dysglycemia group were higher than that in the control group with statistical difference (P＜0.05).The incidence of multi-branches stenosis was higher than that of single-branch stenosis in the dysglycemia group.The incidence of anterior circulation stenosis in control,pre-diabetes and diabetes groups increased with significant difference (P＜0.05).Conclusions Dysglycemia related atherosclerotic stenosis maybe stemmed from early stage ofpre-diabetes,and early measurement and administration ofatherosclerotic stenosis should be taken from the early stage.