冠状动脉血流储备与新诊断2型糖尿病患者动脉粥样硬化的相关性

目的 研究冠状动脉血流储备与新诊断2型糖尿病患者动脉粥样硬化的相关性.方法 内分泌科门诊新诊断2型糖尿病患者80例,经颈、髂、股动脉血管超声检查,按是否伴有动脉粥样斑块分为糖尿病非斑块组40例和糖尿病斑块组40例.另选择年龄、性别相匹配的健康体检者40例为对照组.采用经胸腔彩色多普勒超声心动图法检测冠状动脉血流储备和动脉内膜中膜厚度(IMT),并将冠状动脉血流储备与动脉内膜中膜厚度、Tei指数等因素做相关分析.结果 与对照组相比,糖尿病患者冠状动脉血流储备明显降低,糖尿病斑块组降低更显著(P均＜0.05)；与糖尿病非斑块组比较,糖尿病斑块组的糖化血红蛋白明显增高(P＜0.05)；糖尿病患者动脉内膜中膜厚度明显大于对照组,斑块组大于非斑块组(P＜0.05).冠状动脉血流储备水平与低密度脂蛋白、体重、体质指数、腰围、臀围、空腹血糖的对数[In(FBG)]、动脉内膜中膜厚度和Tei指数呈负相关(P＜0.05).结论 冠状动脉血流储备降低与新诊断2型糖尿病患者动脉粥样硬化程度有较好的相关性,冠状动脉血流储备检测是预测新诊断2型糖尿病患者动脉粥样硬化的良好指标.

Correlation Between Coronary Flow Reserve and Atherosclerosis of Newly Diagnosed Type 2 Diabetic Mellitus

Aim To study the correlation between coronary flow reserve(CFR),HbAlc and atherosclerosis of newly diagnosed type 2 diabetic mellitus. Methods 80 cases with newly diagnosed type 2 diabetic mellitus were divided into diabetic plaque group and diabetic non-plaque group through ultrasonic examination of neck,iliac and femoral vascular.40 health people were chosen as control group.CFR and IMT were measured by transpleural color doppler ultrasound cardiogram,and the results were analyzed with Tei index. Result Compared with control group,CFR of diabetic patients were obviously decreased,while plaque group had the lowest CFR(P<0.05);compared with non-plaque group,HbAlc of plaque group was obviously increased(P<0.05).IMT of diabetes patients was obviously bigger than control group,while in plaque group it was bigger than that in non-plaque group(P<0.05).The level of CFR was negatively correlated with low density lipoprotein,body mass,PWI,waist circumference,hip circumference,ln(FBG) of fasting blood glucose,IMT and Tei index(P<0.05). Conclusion CFR decreased with newly diagnosed type 2 diabetic patients and had good correlation with atherosclerosis.CFR testing is a predictor of newly diagnosed type 2 diabetic patients with atherosclerosis.