合并各类危险因素的2型糖尿病患者冠状动脉病变影像学特征

背景：随着2型糖尿病患病率的上升，人们应重视其心血管并发症的早期干预，以降低其并发症的发病率。目的：观察2型糖尿病合并冠心病危险因素及冠状动脉造影情况。设计：以患者为研究对象，横断面的观察对比研究。单位：一所市级医院的内科病房。对象：实验于1998—05／2003—05在哈尔滨市第一医院内分泌科完成。纳入标准：符合1997年ADA确定的糖尿病诊断标准及1979年WHO制定的《缺血性心脏病的命名和诊断标准》的大于30岁的2型糖尿病合并冠心病患者；排除标准：患有严重心、肝、肾疾病及严重的感染，风湿性心脏病、肺源性心脏病者。98例住院患者符合上述纳入标准，设为糖尿病组，男56例，女42例，年龄为35—70岁。对照组为同期住院的非糖尿病冠心病患者85例，男53例，女32例，年龄为40一75岁。方法：观察血糖(葡萄糖氧化酶法)、空腹胰岛素和C肽(放免法)、糖化血红蛋白(亲和层析微柱法)血清三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇(全自动生化仪)及应用JUDKINS方法行选择性左右冠状动脉造影。主要观察指标：①2组冠状动脉造影结果比较；②糖尿病病程与冠状动脉病变支数关系的比较。结果：2组冠状动脉造影结果比较，糖尿病组的左主干病变、回旋支病变者与对照组相比，差异无显著性意义(P&;gt;0．05)；而前降支和右冠状动脉的病变者糖尿病组多于对照组(P&;lt;0．05)，并且糖尿病组的病变表现为3支病变和单支病变为主，呈现为弥漫性改变。2型糖尿病患者的冠状动脉病变多数是3支血管病变，其病变弥漫，且随病程越长，越易发生多支血管病变。结论：2型糖尿病患者随着病程的延长，冠心病的发生逐渐增多，且病变范围广，病情较严重。     

老年冠心病患者冠状动脉病变特点及相关危险因素分析

目的观察老年冠心病患者（包括高龄老年患者）冠状动脉影像学特点和临床特征，分析老年冠心病各危险因素与冠状动脉病变程度的相关性。方法选择冠状动脉造影确诊为冠心病的患者280例，按年龄不同分为3组：中年组（〈60岁），普通老年组（60岁≤年龄〈75岁），高龄老年组（≥75岁）。所有患者均在入院后测定空腹血糖、血脂、尿酸等生化指标；测量身高、体重；调查既往史；同期行冠状动脉造影及超声心动图检查。冠状动脉狭窄程度根据美国心脏协会（AHA）1975年分类标准评价，冠状动脉的危险因素应用Spearman相关分析。结果①普通与高龄老年组冠状动脉积分较中年组高，高龄老年组最明显（P〈0．01）；普通与高龄老年组右冠状动脉（RCA）病变比例均升高，高龄老年组右冠状动脉积分高于普通老年组（P〈0．05）。②普通与高龄老年组左心室射血分数（LVEF）均较中年组明显减低（P〈0．05），高龄老年组比普通老年组更低（P〈0．05）。③年龄、左心室质量指数、左心室射血分数、空腹血糖水平、低密度脂蛋白胆固醇水平及高血压、糖尿病、心肌梗死病史与冠状动脉积分明显相关。结论老年冠心病患者冠状动脉病变广泛而严重，且心功能差，高龄老年患者更明显；年龄因素不可控制，因此积极干预其他危险因素如高血压、糖尿病、高血脂等甚为重要。     

冠心病合并与不合并2型糖尿病患者的冠状动脉病变特征：60例配对对照

目的：观察冠心病合并2型糖尿病患者的冠状动脉造影特点。方法：选择2003-01／2003-10在锦州医学院附属第一医院心内科冠心病合并2型糖尿病的住院患者60例(合并糖尿病组)。所有患者均自愿参加。选择本院同期心内科住院性别、年龄、体质量指数、血压与合并糖尿病组患者相匹配的不合并糖尿病的冠心病患者60例为不合并糖尿病组。采用Judkins冠状动脉造影法对合并糖尿病组和不合并糖尿病组的患者进行常规多体位照射，观察冠状动脉病变支数、范围及程度。结果：按意向处理分析，最终进入结果分析冠心病合并2型糖尿病和未合并2型糖尿病患者各60例。①两组的病变血管分布情况相似．但合并糖尿病组右冠状动脉病变例数明显高于未合并糖尿病组(48，37例，χ^2=4．88，P&;lt;0．05)。②合并糖尿病组和未合并糖尿病组患者单支、双支、三支病变例数比较基本相似(10，17，33例；17，15，28例，P&;gt;0．05)。③两组的弥漫性病变血管数量(89／74，χ^2=0．94，P=0．33)以及平均累计支数比较无明显差异【89条，(2．38&;#177;0．85)支；74条，(2．18&;#177;0．76)支，P&;gt;0．05】。④合并糖尿病组和未合并糖尿病组患者在冠状动脉50％。74％狭窄，75％-90％狭窄，9l％狭窄至完全闭塞的血管病变程度的数量比较无明显差异(88，89，45条；71，78，47条，P&;gt;0．05)。结论：合并与不合并糖尿病的冠心病患者的血管病变，除了在右冠状动脉累及数量有差异外，在冠状动脉病变的严重性和范围等方面基本一致。     

冠心病合并与不合并2型糖尿病患者的冠状动脉病变特征60例配对对照

目的:观察冠心病合并2型糖尿病患者的冠状动脉造影特点。方法:选择2003-01/2003-10在锦州医学院附属第一医院心内科冠心病合并2型糖尿病的住院患者60例(合并糖尿病组)。所有患者均自愿参加。选择本院同期心内科住院性别、年龄、体质量指数、血压与合并糖尿病组患者相匹配的不合并糖尿病的冠心病患者60例为不合并糖尿病组。采用Judkins冠状动脉造影法对合并糖尿病组和不合并糖尿病组的患者进行常规多体位照射,观察冠状动脉病变支数、范围及程度。结果:按意向处理分析,最终进入结果分析冠心病合并2型糖尿病和未合并2型糖尿病患者各60例。①两组的病变血管分布情况相似,但合并糖尿病组右冠状动脉病变例数明显高于未合并糖尿病组(48,37例,χ2=4.88,P<0.05)。②合并糖尿病组和未合并糖尿病组患者单支、双支、三支病变例数比较基本相似(10,17,33例;17,15,28例,P>0.05)。③两组的弥漫性病变血管数量(89/74,χ2=0.94,P=0.33)以及平均累计支数比较无明显差异犤89条,(2.38±0.85)支;74条,(2.18±0.76)支,P>0.05犦。④合并糖尿病组和未合并糖尿病组患者在冠状动脉50%～74%狭窄,75%～90%狭窄,91%狭窄至完全闭塞的血管病变程度的数量比较无明显差异(88,89,45条;71,78,47条,P>0.05)。结论:合并与不合并糖尿病的冠心病患者的血管病变,除了在右冠状动脉累及数量有差异外,在冠状动脉病变的严重性和范围等方面基本一致。     

冠心病危险因素与冠状动脉病变程度的关系

我们对选择性冠状动脉造影的病例,以Gensini积分进行定量评价冠状动脉病变程度,旨在探讨危险因素与冠状动脉病变程度的关系.     

急性冠状动脉综合征非ST段抬高患者心血管危险因素及其影像学特征

目的：分析比较非ST段抬高的急性冠状动脉综合征与ST段抬高的急性心肌梗死患者的心血管危险因素和影像学特征.方法：选择2003-01/2004-04在南方医科大学南方医院心内科住院并接受冠脉造影的冠心病患者,按照2002年美国心脏病学学院/美国心脏协会不稳定型心绞痛和非ST段抬高心肌梗死治疗指南及2000年中华医学会心血管病学分会的不稳定性心绞痛诊断和治疗建议进行诊断分类.非ST段抬高的急性冠状动脉综合征患者33例（非ST段抬高组）,男30例,女3例.ST段抬高的急性心肌梗死患者33例（ST段抬高组）,男27例,女6例.对两组患者的心血管危险因素和影像学特征进行对比统计分析.结果：进入结果分析非ST段抬高急性冠状动脉综合征患者33例,ST段抬高急性心肌梗死患者33例.非ST段抬高组与ST段抬高组具有相同程度的冠心病危险因素年龄、血脂紊乱、高血压、肥胖、合并糖尿病、有吸烟史、有早发冠心病家族史（P＞0.05）.非ST段抬高组患者具有2个以上心血管危险因素,其病变血管数与ST段抬高组相似;冠状动脉狭窄程度重于ST段抬高组[狭窄程度＜50%：8,3例;50%～74%：9,9例;75%～99%：53,43例;100%：1,20例,Z=3.45,P=0.001],但＞75%以上严重的狭窄病变占总病变的76%.严重狭窄病变形态差于ST段抬高组（Z=3.23,P=0.001）.结论：非ST段抬高的急性冠状动脉综合征与ST段抬高的心肌梗死患者具有相似的危险因素;ST段抬高的急性心肌梗死患者冠状动脉狭窄更严重,而且较严重的病变形态多于非ST段抬高的急性冠脉综合征患者.     

2型糖尿病患者冠状动脉病变的危险因素分析

目的：探讨糖尿病患者冠状动脉病变的危险因素和冠状动脉CT血管造影（CTangiography,CTA）检查的安全性。方法：从2009年8月2010年7月在复旦大学附属中山医院内分泌科住院的诊断为2型糖尿病且行冠脉CTA检查的患者中随机选择34例,根据冠脉病变支数及冠脉病变血管狭窄的程度将其分咸阳性、阴性两组,分别比较患者的糖、脂代谢指标及冠脉CTA检查前后的肾功能等指标的变化。结果：冠脉病变阳性组较阴性组糖尿病痛程长、空腹血糖及糖化血红蛋白（HbAlc）水平高（P均〈0．05）。偏相关分析显示,校正了性别、年龄、BMI后,冠脉病变支数与糖尿病病程、空腹血糖、HbAlC、24h尿微量白蛋白呈正相关,而与C肽增值呈负相关（P均〈0．05）。冠脉CTA检查前后血肌酐差异无统计学意义（P〉0．05）。结论：病程长、HbAlc水平高的糖尿病患者,发生无症状冠心病的风险高,需进行冠心病筛查;对肾功能正常的糖尿病患者进行冠脉CTA检查是安全的。     

冠心病合并2型糖尿病冠状动脉影像学特点分析

目的 分析冠心病合并2型糖尿病(DM)冠状动脉病变影像学特点.方法 选择冠状动脉造影确诊冠心病319例,其中伴有2型糖尿病113例,非糖尿病206例,病变由冠状动脉病变支数和冠状动脉病变程度表示、结果 非DM组以单支血管病变为主,DM组三支病变多且重度狭窄高于非DM组.结论 冠心病合并2型糖尿病者冠状动脉病变的狭窄程度和病变支数较非糖尿病者严重.     

急性冠状动脉综合征非ST段抬高患者心血管危险因素及其影像学特征

目的：分析比较非ST段抬高的急性冠状动脉综合征与ST段抬高的急性心肌梗死患者的心血管危险因素和影像学特征。 方法：选择2003-01／2004-04在南方医科大学南方医院心内科住院并 接受冠脉造影的冠心病患者，按照2002年美国心脏病学学院／美国心脏协会不稳定型心绞痛和非ST段抬高心肌梗死治疗指南及2000年中华医学会心血管病学分会的不稳定性心绞痛诊断和治疗建议进行诊断分类。非ST段抬高的急性冠状动脉综合征患者33例(非ST段抬高组)，男30例，女3例。ST段抬高的急性心肌梗死患者33例(ST段抬高组)，男27例，女6例。对两组患者的心血管危险因素和影像学特征进行对比统计分析。 结果：进入结果分析非ST段抬高急性冠状动脉综合征患者33例，ST段抬高急性心肌梗死患者33例。非ST段抬高组与ST段抬高组具有相同程度的冠心病危险因素年龄、血脂紊乱、高血压、肥胖、合并糖尿病、有吸烟史、有早发冠心病家族史(P>0．05)。非ST段抬高组患者具有2个以上心血管危险因素，其病变血管数与ST段抬高维相似；冠状动脉狭窄程度重于ST段抬高组[狭窄程度<50％：8，3例；50％～74％：9，9例；75％～99％：53，43例；100％：1，20例，Z=3．45，P=0．001]，但>75％以上严重的狭窄病变占总病变的76％。严重狭窄病变形态差于ST段抬高组(Z=3．23，P=0．001)。 结论：非ST段抬高的急性冠状动脉综合征与ST段抬高的心肌梗死患者具有相似的危险因素；ST段抬高的急性心肌梗死患者冠状动脉狭窄更严重，而且较严重的病变形态多于非ST段抬高的急性冠脉综合征患者。     

糖尿病合并冠心病患者的冠状动脉病变特点

目的探讨糖尿病合并冠心病患者的冠状动脉病变特点及相关因素。方法对48例60岁以上临床糖尿病可疑合并冠心病患者行选择性左、右冠状动脉造影,并与同年龄组的非糖尿病患者50例对照。结果98例冠状动脉造影,有病理改变者58例,阳性率59.18%。共累积病变血管168支,其中男性79例,冠造阳性者51例(64.56%),女性19例,冠造阳性者7例(36.84%),差异显著(P<0.01)。糖尿病合并临床可疑冠心病患者48例(A组)与同年龄组的非糖尿病患者对照(B组),冠状动脉造影阳性率分别为70.83%及48.00%,差异显著(P<0.05)。其中A组单支血管病变10例(29.41%),多支血管病变24例(70.59%)。B组单支血管病变11例(45.83%),多支血管病变13例(54.17%),A组多支血管病变数明显高于B组,差异显著(P<0.05)。结论糖尿病临床可疑合并冠心病患者的冠状动脉造影阳性率明显高于非糖尿病的可疑冠心病组,且以多支血管病变为主。     

Inflammation and coronary angiography in asymptomatic type 2 diabetic subjects

Objective. Coronary artery disease (CAD) is prevalent in patients with type 2 diabetes mellitus (T2DM) and because it is often asymptomatic and extensive in comparison with CAD in subjects without diabetes, it represents a diagnostic challenge. The objective of the study was to investigate the prevalence of CAD in asymptomatic T2DM patients utilizing angiography and to investigate its association with cardiovascular (CV) risk factors, the metabolic syndrome and markers of inflammation. Material and methods. Eighty‐two patients with T2DM without symptoms of CAD, and with ?1 CV risk factor (hypertension, dyslipidaemia, premature familial CAD, smoking or microalbuminuria) underwent a diagnostic stress test and coronary angiography irrespective of stress test results. Stenosis detected in the main coronary arteries ?50% of lumen diameter was categorized as one‐, two‐ or three‐vessel disease. Inflammatory markers were analysed in fasting samples. Results. Fifteen men and two women had significant CAD (21%) (1‐vessel disease, n = 10; 2‐ or 3‐vessel disease, n = 7). Patients with 2‐ or 3‐vessel disease were significantly older and had a longer duration of diabetes, but the prevalence of other traditional CV risk factors or the metabolic syndrome was similar among those with 1‐vessel and those with 2‐ or 3‐vessel disease. Sensitivity for CAD of the stress test was low (0.35). The mean level of the pro‐inflammatory marker interleukin‐6 was elevated in patients with 2‐ to 3‐vessel CAD as compared to patients with no or 1‐vessel CAD (p<0.05). Conclusions. Significant CAD was found in 21% of asymptomatic patients with T2DM with ?1 CV risk factor. Inflammatory markers may be helpful in identifying patients that are likely to have significant CAD, but larger studies are warranted.     

Inflammation and coronary angiography in asymptomatic type 2 diabetic subjects

OBJECTIVE: Coronary artery disease (CAD) is prevalent in patients with type 2 diabetes mellitus (T2DM) and because it is often asymptomatic and extensive in comparison with CAD in subjects without diabetes, it represents a diagnostic challenge. The objective of the study was to investigate the prevalence of CAD in asymptomatic T2DM patients utilizing angiography and to investigate its association with cardiovascular (CV) risk factors, the metabolic syndrome and markers of inflammation. MATERIAL AND METHODS: Eighty-two patients with T2DM without symptoms of CAD, and with >or=1 CV risk factor (hypertension, dyslipidaemia, premature familial CAD, smoking or microalbuminuria) underwent a diagnostic stress test and coronary angiography irrespective of stress test results. Stenosis detected in the main coronary arteries >or=50% of lumen diameter was categorized as one-, two- or three-vessel disease. Inflammatory markers were analysed in fasting samples. RESULTS: Fifteen men and two women had significant CAD (21%) (1-vessel disease, n=10; 2- or 3-vessel disease, n=7). Patients with 2- or 3-vessel disease were significantly older and had a longer duration of diabetes, but the prevalence of other traditional CV risk factors or the metabolic syndrome was similar among those with 1-vessel and those with 2- or 3-vessel disease. Sensitivity for CAD of the stress test was low (0.35). The mean level of the pro-inflammatory marker interleukin-6 was elevated in patients with 2- to 3-vessel CAD as compared to patients with no or 1-vessel CAD (p<0.05). CONCLUSIONS: Significant CAD was found in 21% of asymptomatic patients with T2DM with >or=1 CV risk factor. Inflammatory markers may be helpful in identifying patients that are likely to have significant CAD, but larger studies are warranted.     

Lack of management of cardiovascular risk factors in type 2 diabetic patients

Effective management of diabetic patients includes comprehensive control for not only blood sugar, but also other cardiovascular risk factors. We assessed whether haemoglobin A1c (A1C) concentrations, blood pressure, low density lipoprotein (LDL) cholesterol levels and microalbuminuria were regularly measured in 281 patients with type 2 diabetes who received care for over 1 year in the Department of Family Medicine located in an urban area of Korea. Subsequently, in patients with A1C > 7%; blood pressure >130/80 mmHg; LDL cholesterol levels >100 mg/dl; or microalbuminuria, we evaluated the status of management for those cardiovascular risk factors. Physicians were most likely to measure A1C levels (98.6%), but less likely to measure microalbuminuria (56.2%), LDL cholesterol (73.7%), or blood pressure (74.4%). Patients whose A1C levels were above the goal (78.2%) were likely to receive optimal therapy. In contrast, only 21.1% of patients with uncontrolled blood pressure and 5.3% of patients with LDL cholesterol levels above the target range received optimal management. Of the 36 patients with microalbuminuria or overt proteinuria, 66.7% took angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Measurement of parameters indicating cardiovascular risk factors in type 2 diabetic patients was not optimal, particularly regular measurements for microalbuminuria and for controlling LDL-cholesterol and blood pressure. These findings indicate a need for greater education of comprehensive cardiovascular management in type 2 diabetic patients and their physicians.     

Cardiovascular risk factors and disease management in type 2 diabetic patients with diabetic nephropathy

OBJECTIVE: The purpose of this study was to assess the prevalence of cardiorenal risk factors, their management in a routine clinical setting, and the actual achievement of international guideline targets in a large cohort of type 2 diabetic patients with diabetic nephropathy. RESEARCH DESIGN AND METHODS: A multicentric cross-sectional study was performed in the Campania region in Italy to evaluate cardiorenal risk factors and their management in light of international guidelines. Overall, 28,550 diabetic patients were screened in the 21 participating centers; 847 (348 male and 449 female) patients with type 2 diabetes and a clinical diagnosis of diabetic nephropathy were recruited. RESULTS: Of these subjects, 749 had microalbuminuria and 98 had macroalbuminuria. Targets for blood pressure, HbA(1c), LDL cholesterol, HDL cholesterol, and triglycerides were reached in, respectively, 17.5, 32.3, 30.7, 47, and 55.2% of the patients. Chronic renal failure (glomerular filtration rate <60 ml/min) was revealed in 41% and anemia in 23.8% of the patients. CONCLUSIONS: This is the first study to investigate a large cohort of type 2 diabetic patients with early and moderate diabetic nephropathy strictu sensu. Notably, impaired renal function can be often diagnosed in these patients even in the presence of microalbuminuria. Thus, clinical diagnosis of diabetic nephopathy allows us to identify a group of patients at very high cardiorenal risk, for whom care is really difficult. We suggest that a correct diagnosis of diabetic nephropathy should always be made and that sodium intake and anemia should be routinely evaluated in these patients.     

2型糖尿病合并骨质疏松症患者的相关危险因素分析

目的:探讨2型糖尿病合并骨质疏松的发病率并分析其发生的相关因素。方法:利用超声骨密度测定仪,检测2型糖尿病患者的骨质疏松情况,通过对2型糖尿病合并骨质疏松患者的年龄、病程、糖化血红蛋白(glucosylatedhemoglobin,HbA1c)、胰岛素敏感性指数(insulinsensitivityindex,ISI)、体质量指数(bodymassindex,BMI)、尿微量白蛋白等指标的分析,以了解2型糖尿病合并骨质疏松的危险因素。结果:在所有患者中,2型糖尿病合并骨质疏松患者平均空腹血糖、平均HbA1c犤(11.9±3.1)mmol/L,(9.9±1.3)%犦与未合并骨质疏松患者犤(9.3±2.2)mmol/L,(8.7±1.0)%犦比较,差异有显著性意义(t=2.13,2.09,P<0.05);合并与未合并骨质疏松患者平均病程、BMI比较,差异有显著性意义(t=2.18,2.33,P<0.05)。结论:高血糖、低BMI和病程长为2型糖尿病合并骨质疏松的高危险因素。     

2型糖尿病视网膜病变发病的危险因素分析

目的探讨2型糖尿病视网膜病变（DR）发生的危险因素。方法对148例2型糖尿病患者可能诱发DR的危险因素血压、血糖、糖化血红蛋白（HbAlC）、血尿素氮（BUN）、血肌酐（Cr）、β2-微球蛋白进行分析。结果148例糖尿病患者患糖尿病视网膜病变61例,占41．1％。发生率与性别无关;其中病程、糖化血红蛋白、空腹血糖、血压、三酰甘油、胆固醇等与DR发生率呈显著正相关关系;与病程有关,病程少于5年和5年以上的发生率差异有统计学意义（P〈0．05）,2型糖尿病伴高血压患者DR发生率与不伴高血压者的发生率差异有统计学意义;血BUN、Cr含量升高DR发生率显著高于健康者。结论病程长、高血糖和高血脂、高血压、肥胖是DR发生的重要危险因素,糖尿病患者应严格控制血糖、血脂、血压可能延缓糖尿病视网膜病变的发生。     

老年2型糖尿病患者股动脉粥样硬化斑块形成的危险因素分析

目的探讨老年2型糖尿病患者股动脉粥样硬化斑块形成的危险因素。方法老年2型糖尿病患者186例,根据彩色多普勒超声检查股动脉有无斑块将其分为斑块组、无斑块组两组,记录所有患者年龄、性别、病程、体质量指数(BMI)、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、餐后2h血糖(PPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、超敏C反应蛋白(CRP)等。结果经超声检出股动脉斑块形成者占83.3%(155/186)入斑块组。两组间年龄、病程、SBP、FPG、PPG、HbA1c、TG、ApoB和CRP差异有统计学意义(P<0.05);Logistic分析显示年龄、性别、病程、SBP、PPG、TG和CRP的增高是老年2型糖尿病股动脉硬化斑块的独立危险因素(P<0.05)。结论老年2型糖尿病股动脉硬化斑块发生率高,且与多种危险因素有关,严格控制这些危险因素对预防及治疗具有重要临床意义。     

2型糖尿病并腔隙性脑梗死患者颈动脉硬化特征及危险因素分析

目的探讨2型糖尿病合并腔隙性脑梗死患者的颈动脉硬化特征及危险因素。方法选择两院的2型糖尿病并腔隙性脑梗死患者94例（腔隙性脑梗死组）和2型糖尿病非腔隙性脑梗死患者84例（非腔隙性脑梗死组）,均行头颅MRI及多普勒超声检查,同时收集病史,测定糖化血红蛋白、血脂及尿酸。结果腔隙性脑梗死组比非腔隙性脑梗死组年龄大、病程长、高血压患病率高、颈动脉内膜中层厚度（CIMT）厚和颈动脉斑块检出率高,分别为年龄（68.3±7.5）岁vs（57.6±8.3）岁、糖尿病病程（10.12±6.44）年vs（7.00±5.16）年、高血压患病率83.0%（78/94）vs 50.0%（42/84）、CIMT（1.07±0.19）mm vs（0.83±0.15）mm,颈动脉斑块阳性率51.1%（48/84）vs 23.8%（20/84）（P〈0.05或〈0.01）。Logistic回归分析显示：年龄、高血压病史、CIMT及斑块是腔隙性脑梗死的独立危险因素（P〈0.05）。CIMT为0.925 mm时预测2型糖尿病发生腔隙性脑梗死的敏感度为80.9%、特异度为76.2%。结论 2型糖尿病患者合并老年、高血压、糖尿病病程长及颈动脉硬化是发生腔隙性脑梗死的高危者,颈动脉超声检查对2型糖尿病患者发生腔隙性脑梗死有预测价值。     

2型糖尿病患者下肢血管病变的相关因素分析

目的　探讨 2型糖尿病患者下肢血管病变的危险因素。方法　应用美国生产AU 4及SPEC TRA彩色双功能超声诊断仪 ,对 95例 2型糖尿病患者下肢动脉进行检测 ,并记录患者年龄、性别、病程和血压 ,同时测定空腹血糖、餐后 2h血糖、糖基化血红蛋白、血脂及 2 4h尿白蛋白。结果　与正常对照组比较 ,糖尿病患者下肢动脉和足背动脉内径变细、内膜增厚 ,峰值流速减慢。糖尿病伴有下肢血管病变患者的病程明显延长 ,血压、糖基化血红蛋白、血脂和 2 4h尿白蛋白排泄率显著增高。结论　高血糖、脂代谢异常、高血压、病程和尿白蛋白排泄增加是 2型糖尿病患者下肢血管病变的危险因素     

糖尿病患病危险因素在初诊青、老年糖尿病人中差异及分析

目的:通过青年及老年初诊2型糖尿病人糖尿病患病危险因素现状的调查,探讨青年2型糖尿病人早发糖尿病的可能原因.方法:499例初诊2型糖尿病人按年龄分为≤39岁组及≥60岁组.调查内容:职业、糖尿病家族史、饮食习惯、体力活动、体格检查、生化检查.结果:≤39岁组病程及最早体重指数持续时间最短,男性、糖尿病家族阳性史、饮食油腻、办公室职员、管理人员、商人构成比高于老年组(P＜0.001).两组空腹及餐后2h血糖及胰岛素、血浆胆固醇、高密度脂蛋白-C差异无显著意义(P＞0.05).结论:青年2型糖尿病人比老年糖尿病人有更强遗传倾向,存在糖尿病患病相关环境因素更显著.因为如此,可能是他们较老年人早发糖尿病的原因.