老年代谢综合征颈动脉粥样硬化特征的研究

目的通过测量颈动脉内膜-中层厚度（IMT）及斑块来探讨代谢综合征与动脉粥样硬化的关系。方法147例门诊及住院的老年病人分为代谢综合征组（MS，52例），高血压病组（EH，54例），糖尿病组（DM，41例）以及正常对照组（30例）。应用彩色多普勒超声技术检测各组人群颈动脉IMT、斑块总积分，粥样斑块发生率。全部入选人员检测血脂、空腹血糖及测量血压、体重指数（BMI）、腰围等。比较四组患者颈动脉超声检测结果及血脂、血糖等变化。结果MS组与EH组、DM组比较：颈总动脉IMT明显增厚（1．12±0．03）mm比（0．99±0．07）mm，（1．12±0．03）mm比（0．87±0．05）mm；分别P〈0．05，P〈0．01]；斑块总积分明显增高（3．57±0．03比2．42±0．03，3．57±0．03比2．43±0．03，均P〈0．01）；MS组颈动脉粥样斑块发生率（61．5％）明显高于EH组（33．3％）、DM组（12．2％），均P〈0．01，有极显著性差异。血脂中MS组甘油三酯明显高于EH组和DM组（P〈0．01，P〈0．05），低密度脂蛋白胆固醇明显高于EH组（P〈0．05），总胆固醇明显高于EH组和DM组。结论MS颈动脉粥样硬化程度较单纯高血压病和糖尿病颈动脉病变更严重，代谢综合征可加速动脉粥样硬化的发生、发展。

Carotid artery atherosclerosis in elderly patients with metabolic syndrome

Objective To explore the relationship between metabolic syndrome (MS) and atherosclerosis by measuring the intima-media thickness (IMT) and the plaque of carotid artery. Methods A tolal of 147 patients were divided into three groups: MS group, essential hypertension (EH) group and diabetes mellitus (DM) group and 30 normal adults served as control group. The thickness of carotid intima-media and the score of plaque were measured with color ultrasonography in all patients. Plasma lipids, fasting plasma glucose, blood pressure, body mass index and waist circumference were measured in all subjects. Results IMT of common carotid artery, the plaque score, plaque occurrence rate were significantly higher in MS group than in EH and DM groups. IMT of common carotid artery in MS group, EH group and DM group was higher than that in control group . Level of TG in MS group was higher than that in EH group and DM group, while the level of LDL-c was obviously higher than that in EH group, and the level of TC was higher than that in EH group and DM group. Conclusion Atherosclerosis of carotid artery was more severe in MS patients than in those with simple hypertension or DM.Metabolic syndrome accelerates the development of atherosclerosis.