糖调节受损患者颈动脉弹性改变及相关因素分析

目的探讨糖调节受损患者颈动脉弹性改变情况并对相关因素进行相关性分析。方法选取2013年6月至2014年6月在枣庄市立医院健康体检者中无糖尿病者170人,根据OGTT实验,分为糖耐量正常组（68例）、糖调节受损组（54例）、初诊糖尿病组（48例）,检测所有入选人员空腹血糖（FBG）、餐后2h血糖（P2hBG）、糖化血红蛋白（HbA1c）、甘油三酯（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）、空腹胰岛素水平（FIns）,计算稳态模型胰岛素抵抗评估指数（HOMA-IR）、（细胞功能指数（HOMA-IS）、胰岛素敏感指数（ISI）;并应用超声血管回声跟踪技术（ET技术）检测患者颈动脉内膜中层厚度（IMT）、颈总动脉扩张性（CD）、单点脉搏波传播速度（PWVβ）和僵硬度（β）。结果与糖耐量正常组相比,糖调节受损组、2型糖尿病组FBG、P2hBG、TG、Ln（FINS）、Ln（HOMA-IR）、Ln（HOMA-IS）、AIP、PWVβ、β均显著升高（P﹤0.05）,CD Ln（ISI）及HDL均明显降低（P﹤0.05）;与糖耐量正常组相比,糖耐量受损组IMT变化不明显,但2型糖尿病组IMT明显增加（P﹤0.05）。相关分析显示：PWVβ、β与P2hBG、HbA1c、SBP、LDL-C呈正相关（P均〈0.05）,CD与P2hBG、HbA1c、SBP、LDL-C呈负相关（P均〈0.05）。结论动脉功能性改变先于结构改变,在糖调节受损期已存在颈动脉弹性改变,对糖尿病前期进行积极血糖、血脂干预有望延缓动脉粥样硬化的进展。

Carotid artery elasticity change in Sugar regulation damaged patients and related factors analysis

Objective：To observe the change of carotid artery elasticity in sugar regulation damaged patients and analy-sis correlation of related factors. Methods：170 people without diabetes were selected in zaozhuang hospital physical exami-nation from June 2013 to June 2013. divided into normal glucose tolerance group（68 cases）,sugar regulation damaged group（54 cases）,new diagnosis of diabetes group（48 cases）,according to the OGTT experiment. fasting blood glucose （FBG）,2 h postprandial blood glucose（P2hBG）,glycosylated hemoglobin（HbA1c）,triglyceride（TG）,high - density lipoprotein（HDL - C）,low density lipoprotein（LDL - C）and fasting insulin（FIns）were tested. Insulin resistance （IR）,islet b cell function index（IS）and islet cells sensitive indices（ISI）were calculated by homeostasis model assess-ment. carotid intima - media thickness（IMT）,carotid artery dilated（CD）,single point pulse wave velocity（PWVβ） and stiffness（β）were measured by Ultrasonic vascular echo tracking technology（ET）. Result：Compared with normal glucose tolerance group,FBG and P2hBG,TG,Ln（FINS）,Ln（HOMA IR）and Ln（HOMA - IS）,AIP,PWVβ,βin Sugar regulation damaged and type 2 diabetes groups were significantly higher（P 〈 0. 05）,but CD Ln（ISI）and HDL -C were obviously lower（P 〈 0. 05）. Compared with normal glucose tolerance group,IMT does not change significantly in impaired glucose tolerance group,but increased significantly in type 2 diabetes mellitus group（P 〈 0. 05）. By Correlation analysis,P2hBG,HbA1c,SBP,LDL - C were positively correlated with PWVβ、β（P 〈 0. 05）,and P2hBG,HbA1c,SBP,LDL - C were negatively correlated with CD（P 〈 0. 05）. Conclusion：Artery functional change ahead of structureˊs, There have been changes of carotid artery elasticity in the sugar regulation damaged,it is possible to delay the progress of atherosclerosis by actively intervent blood sugar,blood fat pre - diabetes.