2型糖尿病患者视网膜病变与颈动脉内膜中层厚度的关系

目的 探讨2型糖尿病患者视网膜病变(DR)与颈动脉内膜中层厚度(IMT)之间的关系.方法 选取2008、2009年在哈尔滨医科大学附属第四医院内分泌科确诊的2型糖尿病患者123例作为观察对象,根据眼底检查结果 分为DR组和非DR(NDR)组.采集病史(病程、吸烟、家族史等),同时检测颈动脉IMT、收缩压、舒张压、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白、体质量指数等指标.两组颈动脉IMT增厚发生率的比较采用χ2检验,两组平均颈动脉IMT值的比较采用独立样本t检验:应用Logistic回归分析糖尿病DR病变的影响因素.结果 ①DR组IMT增厚的发生率为50.98%(26/51),NDR组为33.33%(24/72),两组比较差异有统计学意义(χ2=3.85,P<0.05).②DR组平均颈动脉IMT值为(1.01±0.23)mm,NDR组为(0.91±0.24)mm,两组比较差异有统计学意义(t=-2.21,P<0.05).③单因素分析糖尿病DR病变的影响因素为;吸烟(χ2=6.20,P<0.05),病程(t=-4.13,P<0.01),高密度脂蛋白胆固醇(t=4.49,P<0.01),颈动脉IMT(t=-2.21,P<0.05),收缩压(t=-2.37,P<0.05).④Logistic回归分析糖尿病DR病变的影响因素为:病程、高密度脂蛋白胆固醇、颈动脉IMT、吸烟(χ2值分别为7.77、12.77、6.05、4.15,P均<0.01或0.05).结论 2型糖尿病DR病变患者颈动脉IMT增厚的比例明显增加,且平均颈动脉IMT厚度亦明显增加.2型精尿病合并DR病变与其颈动脉IMT厚度之间关系密切.

Relationship between type 2 diabetic retinopathy and the carotid artery intima-media thickness

Objective To explore the relationship between the diabetic retinopathy (DR) and the carotid artery intima-media thickness(IMT) in type 2 diabetic patients to reveal the relationship between macroangiopathy and microangiopathy in diabetic patients further. Methods One hundred and tweenty-three diabetic cases in patient chosen from 2008 to 2009 were divided into diabetic retinopathy group(DR) and non-diabetic retinopathy group(NDR) by fundus examination. The patients were asked about their disease history including durations, smoking and so on. Meanwhile the carotid artery IMT, systolic pressure (SBP), diastolic pressure (DBP), serum total cholesterol, triglycerides, high density lipoprotein (HDL)-cholesterol, low density lipoprotein (LDL)-cholesterol, glycosylated hemoglobin(HbAlc), body mass index(BMI) were measured of all the cases. The incidence of increased carotid artery IMT was cmpared with χ2 test, as well as the average IMT between the two groups, the influencing factors artery IMT was 50.98%(26/51) in DR group, and 33.33%(24/72) in NDR group, having a statistically significant showed the diabetic retinopathy risk factors were smoking(χ2=6.20, P<0.05), duration(t=-4.13, P<0.01). carotid artery IMT(t=-2.21, P<0.05), SBP(t=-2.37, P<0.05), and HDL-cholesterol(t=4.49, all P<0.01). 12.77, all P<0.01), carotid artery 1MT and smoking(χ2=6.05,4.15, all P<0.05). Conclusions Type 2 diabetic patients complicated with DR have a prominent increase in IMT thickening proportion and average IMT, which reveals the relationship between the DR and the IMT.