多因素干预下糖化血红蛋白对新诊2型糖尿病患者颈动脉内中膜厚度的影响

目的探讨多危因素强化干预条件下，糖化血红蛋白（HbAlc）水平对新诊2型糖尿病（T2DM）患者颈总动脉内中膜厚度（CCA-IMT）的预测作用。方法对90例病程1年以内的T2DM患者进行以抗血小板聚集为基础的强化血糖、血压、血脂及体重等综合干预治疗，以ACCA-IMT值是否≥0．02mm为界限，将T2DM患者分为CCA-IMT增厚组及非增厚组，比较强化干预1年前、后2组患者间代谢指标的差异及其与CCA-IMT增厚的关系。采用Logistic回归分析探讨影响CCA-IMT增厚的危险因素。结果经1年多因素强化治疗后，90例新诊T2DM患者中CCA-IMT增厚组患者24例，非增厚组66例；CCA-IMT增厚组患者有吸烟史、饮酒史、高血脂史、高血压史的比例及患者的年龄显著高于非增厚组患者（P〈0．05）；CCA-IMT增厚组患者HbAlc的下降幅度即△HbAlc[0．20（5．90～-2．80）：1．20（9．30～-2．70）]明显小于非增厚组（P〈0．05）；Logistic回归分析结果显示与CCA-IMT增厚密切关联的因素有年龄、△HbAlc。结论对新诊T2DM采取多危因素强化干预条件下，HbAlc的下降幅度能够预测CCA-IMT的进展。

Effect of HbA1c on the carotid intima-media thickness under the multifactorial intervention in newly diagnosed type 2 diabetes

Objective To investigate the relationship between glycosylated haemoglobin （HbAlc） levels and intimamedia thicknesses of the common carotid artery （CCA-IMT） and the predicting effect of HbAlc on CCA-IMT in newly diagnosed type 2 diabetes （T2DM）. Methods Ninety newly diagnosed type 2 diabetics （≤lyear） received the multifactorial targeted intervention, including taking aspirin and controlling blood glucose, blood pressure, blood lipid and body weight. After 1 year, the 90 patients were divided into 2 groups according to the differences of CCA IMT. The differences of metabolic control were analyzed. Logistic regression analysis was used to disclose the correlation between CCA IMT and macrovascular risk factors. Results AHbAlc, was lower than that in the CCA-IMT non-increasing group. Logistic regression analysis showed that age, AHbAlc, and age were closely correlated with CCA-IMT. Conclusion Under the multifactorial intervention for 1 year, age and AHbAlc may predict the progression of CCA-IMT in patients with newly diagnosed type 2 diabetes.