老年女性2型糖尿病患者颈动脉内膜中层厚度相关因素分析.docVIP

老年女性2型糖尿病患者颈动脉内膜中层厚度相关因素分析 　【摘要】 目的 研究老年女性2型糖尿病患者颈动脉内膜中层厚度(IMT)的相关因素。方法 将205例2型糖尿病患者分为老年女性组，非老年女性组、老年男性组和非老年男性组，比较各组颈动脉IMT差异；将老年女性组分为内膜正常组、内膜增厚组、斑块形成组、管腔狭窄组，比较各组间尿白蛋白排泄率（UAER）、血糖、血脂等。对颈动脉IMT异常的老年女性患者，采用多元逐步回归分析颈总动脉IMT和UAER、血糖、血脂等之间的关系。结果 （1）老年女性组和非老年女性组比较IMT显著增厚；（2）非老年男性组和非老年女性组比较IMT显著增厚；老年女性组和老年男性组比较无显著性差异；（3）老年女性患者中斑块形成组和管腔狭窄组与内膜正常组比较，UAER显著增加。（4）相关分析发现老年女性2型糖尿病患者平均IMT值与UAER、收缩压呈正相关，与高密度脂蛋白胆固醇呈负相关。结论 2型糖尿病患者颈动脉硬化程度存在性别、年龄差异，老年女性2型糖尿病患者平均IMT值与收缩压、UAER呈正相关。 【关键词】 2型糖尿病 尿白蛋白排泄率 颈动脉内膜中层厚度 老年 女性 【Abstract】 Objective To investigate the correlated risk factors influencing carotid intimamedia thickness (IMT) in aged female with type 2 diabetes mellitus (T2DM). Methods 205 T2DM patients were divided into aged female group, none-aged female group, aged male group and none-aged male group. The IMT was compared among the four groups. The aged female group was divided into normal group, intima thickening group, the plaque shaping group and the vascular stenosis group. In the abnormal group, probable risk factors were analyzed by multiple stepwise regression. Results (1)The IMT was significantly different between aged female group and none-aged female group; (2)The IMT was significantly different between none-aged female group and none-aged male group, there was no significantly different between aged female group and aged male group; (3)UAER was significantly different among normal group, intima thickening group, the plaque shaping group and the vascular stenosis group. (4)The IMT was correlated with UAER and SBP in aged female with T2DM. Conclusions The IMT is different in different ages and sex. The IMT is correlated with UAER and SBP in aged female with T2DM. 【Key words】 Type 2 diabetes mellitus UAER Intima medial thickness Aged female 　 近年来研究表明颈总动脉内膜中层厚度(IMT)可作为预测心血管患病和病死率的独立因素，高敏感型超声测定IMT是诊断亚临床期动脉粥样硬化的一个非浸润性定量指标，能预测心脑血管事件的发生发展及程度［1,2］。动脉粥样硬化的发病率存在着性别差异，女性绝经前发病率显著低于男性,绝经后发病率剧增,短期内达到与男性相近水平，这可能与体内性激素水平的变化有密切关系。因此，了解老年女性IMT的变化及其相关因素对心血管疾病的防治具有临床意义。 1 临床资料 1.1 一般资料 2005年