型糖尿病住院患者非酒精性脂肪性肝病与颈动脉粥样硬化关系.docVIP

2型糖尿病住院患者非酒精性脂肪性肝病与颈动脉粥样硬化的关系 【摘要】 目的 ：探讨2型糖尿病住院患者非酒精性脂肪性肝病(NAFLD)与颈动脉粥样硬化的关系。方法：入选141例2型糖尿病住院患者，根据B超检查结果分为NAFLD组和无NAFLD组，均接受双颈动脉彩色多普勒超声检查，测定其内中膜厚度(IMT)，观察有无斑块形成及管腔狭窄。结果 ：2型糖尿病合并NAFLD组颈动脉IMT增厚32例(占32.32%)，斑块形成51例(占51.51%)，管腔狭窄11例(占11.11%);2型糖尿病无NAFLD组颈动脉IMT增厚12例(占28.57%)，斑块形成8例(占19.04%)，管腔狭窄0例，两组比较，差异有显著性(均P lt;0.01)。结论 ：2型糖尿病住院患者NAFLD与颈动脉粥样硬化关系密切，对已知2型糖尿病合并NAFLD患者尽早行多部位血管超声检查有重要意义。 【关键词】 糖尿病，2型;非酒精性脂肪性肝病;动脉粥样硬化 　　Abstract: Objective: To explore the relationship between non-alcoholic fatty liver disease (NAFLD) and carotid atherosclerosis in hospitalized type 2 diabetics. Methods: One hundred and forty-one hospitalized Type 2 diabetics were divided into NAFLD group and non-NAFLD group according to the liver B ultrasonography results， Their intima-media thickness (IMT) was detect and athero-sclerotic plaque and vessel stenosis were observed with carotid artery B-ultrasound examination. Results: In type 2 diabetics with NAFLD group，32 cases (32.32%)showed carotid IMT， 51 cases (51.51%) formation of atherosclerotic plaque，and 11 cases (11.11%) vessel stenosis ;12 cases(28.57%)showed carotid IMT，8 cases(19.04%)formation of atheroscle-rotic plaque，and no vessel stenosis in the non-NAFLD group. Thus，there was a significant difference between two groups (P lt;0.01). Conclusion: There is a close relationship between NAFLD and atherosclerosis in hospital-ized Type 2 diabetics. To do artery B-ultrasound examination early in Type 2 diabetics with NAFLD is of great significance. 　　Key words: type 2 diabetes;non-alcoholic fatty liver disease;atherosclerosis 　　非酒精性脂肪性肝病与肥胖、糖脂代谢紊乱、胰岛素抵抗等代谢综合征组分相关，其与动脉粥样硬化关系如何尚不明确。本研究通过对2型糖尿病住院患者行肝脏及颈动脉超声检查，探讨其非酒精性脂肪性肝病与颈动脉粥样硬化的关系，为2型糖尿病患者更好防治动脉粥样硬化预防心脑血管疾病提供依据。 　　1 对象和方法 　　1.1 研究对象 选取2008年3月至2008年12月在我科住院的2型糖尿病患者141例，年龄40～70岁。按肝脏B超检查结果分为NAFLD组99例，男56例，女43例;无NAFLD组42例，男24例，女18例，2型糖尿病诊断按1999年WHO诊断标准，非酒精性脂肪性肝病诊断符合中华医学会肝脏病学分会脂肪肝和酒精性肝病学组2006年修订的《非酒精性脂肪性肝病诊断标准》[1]。 　　1.2 检查项目 全部对象记录病程、测身高体重，计算体重指数(BMI)，测定血压;取清晨空腹静脉血，全自动生化分析仪测定血脂、超敏C反应蛋白(hs-CRP)、糖化血红蛋白