糖尿病合并高血压患者颈动脉粥样硬化斑块发生率的探讨

目的:探讨2型糖尿病合并高血压患者颈动脉粥样硬化斑块的发生率。方法:选择2型糖尿病合并高血压患者90例,高血压患者78例,以50例健康体检者作为健康对照组,测量血压、体重指数、血清超敏C反应蛋白(hs-CRP)、血清总胆红素、直接胆红素、间接胆红素、血脂、血糖、血尿酸、糖化血红蛋白(HbA1C)并行颈部血管B超检查,比较3组间上述临床生化指标及颈动脉血管B超检查结果;同时根据HbA1C水平,90例2型糖尿病合并高血压患者被分成两组,进一步比较颈动脉血管B超检查结果。结果:①血清hs-CRP水平在2型糖尿病合并高血压组(3.76±4.83)mg/L及高血压组(2.21±3.73)mg/L明显高于健康对照组[(2.08±2.85)mg/L,P0.05];②2型糖尿病合并高血压组颈动脉粥样硬化斑块的发生率明显高于高血压组及健康对照组(80.00%:62.82%:40.00%,P均0.001);③HbA1C≥6.5%组的颈动脉粥样硬化斑块的发生率明显高于HbA1C6.5%组的(86.21%:68.75%,P0.05)。结论:糖尿病及高血压均可增加颈动脉粥样硬化斑块的发生率,HbA1C≥6.5%组的颈动脉粥样硬化斑块的发生率更高,糖尿病和高血压患者应检查颈动脉粥样硬化斑块,早期诊断动脉硬化,改善预后。

Incidence of carotid atherosclerotic plaque in patients with hypertension and diabetes mellitus

Objective： To investigate the incidence of carotid atherosclerotic plaque in patients with hypertension and diabetes mellitus. Methods： Doppler with two-dimensional ultrasound was performed in 90 patients with hypertension and diabetes mellitus, 78 hypertensive patients and 50 healthy persons as normal control group. Blood pressure, body mass index （BMI）, the serum high sensitive C-reaction protein （hs-CRP）, serum levels of direct bilirubin （DBIL）, indirect bilirubin （IBIL）, total bilirubin （TBIL）, uric acid （UA）, glucose, serum lipids, and HbA1C were measured in each group. The 90 patients with hypertension and diabetes mellitus were divided in to HbAlc ≥6.5 % group and HbA1C 〈6.5 % group according to HbA1C level and compared the incidence of carotid atherosclerotie plaque between the two groups. Results： OThe hs-CRP in patients with hypertension and diabetes mellitus [ （3.76±4.83） mg/L], and hypertension [ （2.21±3.73） mg/L] was higher than that of normal control group [ （2.08±2.85） mg/L]; （P〈 0.05 all）; （2） The incidence of carotid atherosclerotic plaque in patients with hypertension and diabetes mellitus （80.00%） was higher than that of hypertensive group （62.82%） and normal control group （40.00%）, P〈0. 001; （3） The incidence of carotid atherosclerotic plaque in HbA1C ≥6.5 % group （82.21 % ） was higher than that of HbAIC 〈6.5, group （68. 75%）, P〈0. 05. Conclusion： The incidence of carotid atheroselerotie plaque in diabetes mellitus and hypertension patients all increase, in HBA1C≥6.5 % group is more high, So it must be detected in these patients, for improve prognosis.