2型糖尿病患者大血管病变相关因素分析

目的研究2型糖尿病(DM)大血管病变(MA)的特点、相关危险因素及临床意义。方法将316例2型DM患者分为有MA组174例,其中缺血性心脏病(IHD)患者80例、脑血管病变(CVD)患者55例、周围血管病变(PVD)患者64例;非MA组142例。所有患者均做口服糖耐量试验(OGTT)、胰岛素释放试验,检测空腹血糖(FPG)、2小时血糖(2h PG)、空腹血清胰岛素(FINS)水平,根据结果计算胰岛素抵抗指数(HOMA-IR);检测瘦素(LEP)、白介素-6(IL-6)、C反应蛋白(CRP)等,对2型DM大血管病变的临床数据进行比较及回归分析。结果(1)MA组的年龄、高血压患病率与非MA组比较有显著性差异(P<0.01);(2)MA组IL-6、CRP与非MA组比较有显著性差异(P<0.05,P<0.01),MA组LEP与非MA组比较无显著性差异(P>0.05);(3)回归分析显示,高血压、年龄是2型DM病患者MA的独立危险因素(P<0.01)。结论年龄、高血压是2型DM患者发生MA的独立危险因素;2型DM合并MA者存在低水平慢性炎症;积极控制血压可能对减少其大血管事件的发生有重要意义。

The analyses for macrovascular diseases in T2DM patients

Objective To study the characteristic features of risk factors for macrovascular disease(MA)in patients with type 2 diabetes.Methods 316 cases of type 2 diabetes were divided into 2 groups:174 cases with MA,including 80 with ischemic heart disease(IHD),55 with cerebrovascular disease(CVD),64 with peripheral vascular disease(PVD).142 cases was without macrovascular disease(MA).The experimental group were taken the oral glucose tolerance test(OGTT) and insulin releasing test,FPG,2hPG,FINS were detected.According to the results Homa-IR was calculated.Leptin(LEP),intenleukiu-6(IL-6),C-reaction protein(CRP) and albumin/creatinine ratio(A/C) were also tested.All clinical data were compared and logistic regression analysis was used to reveal the risk factors for MA.Results The old age,hypertension were significantly increased in patients with MA compared with patients without MA(P<0.01).(2) The IL-6,CRP and A/C were all higher than that in patients with MA compared with patients without MA(P<0.05,P<0.01).LEP were alike than that in patients with MA compared with patients without MA(P>0.05).(3)With stepwise multivariate logistic regression analysis,old age and hypertension were identified as significant and independent risk factors for MA(P<0.01).Conclusion In T2DM patients,the older age and hypertension are found to be risk factors for MA.There may be a chromic inflammatory reaction in patients with type 2 diabetes with macrovascular disease.It seem to be crucial to give them tight blood pressure control for the prevention of MA in T2DM patients.