摘要
目的:比较成人1型和2型糖尿病患者动脉粥样硬化病变,并分别在成人1型和2型糖尿病患者中比较自身颈动脉和下肢动脉粥样硬化病变。方法:选取2007年1月至2009年6月上海交通大学附属第六人民医院内分泌代谢科住院的年龄在18岁及以上成人1型糖尿病患者192例和成人2型糖尿病患者196例。应用血管多普勒超声评估颈动脉和下肢动脉粥样硬化病变包括动脉内膜-中层厚度、斑块和狭窄。首先比较成人1型和2型糖尿病患者动脉粥样硬化病变,然后分别在两组人群中比较颈动脉和下肢动脉粥样硬化病变。组间比较采用t检验,一致性检验采用Kappa系数检验。结果:校正年龄、性别和糖尿病病程后,成人2型糖尿病患者颈动脉内膜-中层厚度明显大于成人1型糖尿病患者[(0.83±0.19)比(0.76±0.17)mm,t=4.882,P<0.05],颈动脉斑块和狭窄患病率(分别为48.0%及9.2%)也明显高于成人1型糖尿病患者颈动脉斑块和狭窄患病率(χ2=24.319、5.828,均P<0.05)。成人1型和2型糖尿病患者下肢动脉斑块(分别为56.8%,χ2=4.314,P<0.05;69.4%,χ2=18.559,P<0.001)和狭窄(χ2=6.534、4.493,均P<0.05)的患病率均明显高于自身颈动脉斑块和狭窄的患病率。结论:成人2型糖尿病动脉粥样硬化病变比成人1型糖尿病更为严重且成人糖尿病患者下肢动脉粥样硬化病变较颈动脉粥样硬化病变更为严重,颈动脉和下肢动脉超声的联合检查对提高成人糖尿病患者动脉粥样硬化的检出率意义重大。
Objective To compare atherosclerotic lesions between adults with type 1 and type 2 diabetes,and carotid with lower extremity atherosclerosis as well.Methods This observational study was carried out in 192 adults with type 1 diabetes and 196 adults with type 2 diabetes(age≥18 years old).Based on Doppler ultrasound,atherosclerotic lesions including intima-media thickness,plaque and stenosis were compared between adults with type 1 and type 2 diabetes.Furthermore,carotid and lower extremity atherosclerosis were compared as well.Results After adjustment for age,gender,and diabetes duration,the carotid intima-media thickness in adults with type 2 diabetes was significantly greater than that in adults with type 1 diabetes[(0.83±0.19)vs(0.76±0.17)mm,t=4.882,P<0.05].The percentage of carotid plaque and stenosis(48.0%and 9.2%,respectively)in type 2 diabetes were significantly higher than those in type 1 diabetes(χ²=24.319,5.828,all P<0.05,respectively).The prevalence of lower limb plaque(χ²=4.314,18.559,all P<0.001 for type 2 diabetes)and stenosis(χ²=6.534,4.493,all P<0.05 for type 2 diabetes)were significantly higher than that of carotid plaque and stenosis in adults with type 1 and in type 2 diabetes,respectively.Conclusions Atherosclerotic lesions in adults with type 2 diabetes are more severe than that in adults with type 1 diabetes.Furthermore,lower limb atherosclerotic lesions are more severe than carotid atherosclerotic lesions in adults with diabetes.The combination of carotid and lower extremity ultrasound examination can significantly improve the detection of atherosclerosis in adults with diabetes.
作者
金春花
柯蒋风
张智慧
李连喜
Jin Chunhua;Ke Jiangfeng;Zhang Zhihui;Li Lianxi(Department of Endocrinology,Songjiang District Central Hospital of Shanghai,Shanghai 201600,China;Department of Endocrinology and Metabolism,Shanghai Jiao Tong University Affiliated Sixth People′s Hospital,Shanghai 200223,China)
出处
《中华糖尿病杂志》
CAS
CSCD
北大核心
2020年第11期879-884,共6页
CHINESE JOURNAL OF DIABETES MELLITUS
基金
国家重点研发计划(2018YFC1314900,2018YFC1314905)
国家自然科学基金(81170759,82070866)
上海市科学技术委员会资助项目(15411960600)。
关键词
糖尿病
1型
糖尿病
2型
颈动脉粥样硬化
下肢动脉粥样硬化
Diabetes mellitus,type 1
Diabetes mellitus,type 2
Carotid atherosclerosis
Lower extremity atherosclerosis
