文章摘要

老年2型糖尿病患者颈动脉粥样硬化与斑块形成的相关危险因素

作者: 1戴 雨濛, 1张 薇薇, 1张 伟, 1孙 梦雯, 1严 光
1 中国科学技术大学附属第一医院(安徽省立医院)老年医学科,合肥 230001
通讯: 孙 梦雯 Email: gaipi@163.com
DOI: 10.3978/j.issn.2095-6959.2020.01.017

摘要

目的:探讨老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者颈动脉粥样硬化(atherosclerosis,AS)与斑块形成及其稳定性的相关影响因素,为其早期预防和治疗提供科学依据。方法:选取中国科学技术大学附属第一医院收治的262例老年T2DM患者,根据颈动脉彩色多普勒超声探查结果分为正常组、硬化组、稳定斑块组和不稳定斑块组,比较4组患者临床资料和生化指标的差异,并采用单因素分析和多因素logistic回归分析筛选老年T2DM患者颈动脉粥样硬化和斑块形成相关影响因素。结果:正常组、硬化组、斑块组病程、血清空腹血糖(fasting blood-glucose,FBG)、糖化血红蛋白(HbA1c)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、总胆红素(total bilirubin,TBIL)、直接胆红素(direct bilirubin,DBIL)、游离三碘甲状腺氨酸(free triiodothyronine,FT3)、游离甲状腺激素(free thyroxine,FT4)、25(OH)VD数值比较差异有统计学意义(P<0.05)。稳定斑块组和不稳定斑块组病程、血清HbA1c,HDL-C,LDL-C和25(OH)VD数值比较差异有统计学意义(P<0.05)。Logistic回归分析:病程长、高FBG和LDL-C是斑块形成的危险因素,高FT3,HDL-C,TBIL和25(OH)VD是保护因素。结论:血清FT3,25(OH)VD和TBIL水平下降促进老年T2DM患者颈动脉粥样硬化与斑块形成。
关键词: 2型糖尿病;颈动脉粥样硬化;斑块;危险因素

Related risk factors of carotid atherosclerosis plaque formation in the elderly patients with type 2 diabetes mellitus

Authors: 1DAI Yumeng, 1ZHANG Weiwei, 1ZHANG Wei, 1SUN Mengwen, 1YAN Guang
1 Department of Geriatrics, First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China (Anhui Provincial Hospital), Hefei 230001, China

CorrespondingAuthor:SUN Mengwen Email: gaipi@163.com

Abstract

Objective: To explore the related influencing factors of carotid atherosclerosis (AS) plaque formation and stability in the elderly patients with type 2 diabetes mellitus (T2DM), and to provide scientific evidence for early prevention and treatment. Methods: A total of 262 elderly patients with T2DM were selected. According to the results of carotid artery color Doppler ultrasound, they were divided into a normal group, an AS group, a stable plaque group and an unstable plaque group. The differences of clinical data and biochemical indicators of patients were compared between the 4 groups; univariate analysis and logistic regression analysis were used to screen the related influencing factors of carotid AS plaque formation and stability of the elderly T2DM patients. Results: The analysis showed that the disease course, serum fasting blood glucose (FBG), hemoglobin A1c (HbA1c), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total bilirubin (TBIL), direct bilirubin (DBIL), free triiodothyronine (FT3), free thyroxine (FT4), 25(OH)VD has significant differences among the normal group, the AS group and the plaque group (P<0.05). The significant differences in the levels of the disease course, serum HbA1c, HDL-C, LDL-C and 25(OH)VD in the stable plaque group and the unstable plaque group (P<0.05). The logistic regression analysis showed that the long disease course, high FBG and LDL-C were the risk factors of plaque formation, high FT3, HDL-C, TBIL, 25(OH)VD were protective factors of plaque formation. Conclusion: The decrease of serum FT3, 25(OH)VD and TBIL level is promoting AS plaque formation in elderly T2DM patients.
Keywords: type 2 diabetes mellitus; carotid atherosclerosis; plaque; risk factors