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老年2型糖尿病合并高血压伴同型半胱氨酸升高患者高敏C反应蛋白与颈动脉硬化和血钙、磷的关系

来自:中国糖尿病杂志  编辑:安增梅 陆颖理 笪应芬|点击数:|2015-04-29

  ·糖尿病大血管并发症·

  【摘要】 目的 探讨老年T2DM合并高血压伴同型半胱氨酸(Hcy)升高患者高敏C反应蛋白(hsC-RP)与颈动脉硬化及血钙(Ca2+)、磷(P3-)的关系。 方法 多普勒超声检查颈动脉内-中膜厚度(CIMT),将105例患者分为颈总动脉正常组(n=30,CIMT<0.9 mm)、颈总动脉硬化组(n=30,0.9 mm≤CIMT<1.2 mm)、颈总动脉斑块组(n=45,CIMT≥1.2 mm);颈总动脉斑块组进一步分为稳定斑块组20例和不稳定斑块组25例。检测各组hsC-RP、Hcy浓度、Ca2+、P3-等。采用Logistic回归分析CIMT的危险因素。 结果 颈总动脉斑块组hsC-RP[(16.88±5.31) vs (11.56±5.52) mg/L]、Hcy[(19.47±10.18) vs (14.93±3.41) μmol/L]、CIMT[(0.98±0.09) vs (0.93±0.05) mm]均高于颈总动脉硬化组(P<0.05),血Ca2+[(2.24±0.3) vs(2.26 ±0.16) mmol/L]、P3-[(1.19±0.25) vs (1.13±1.14) mmol/L]比较,差异无统计学意义(P>0.05)。颈总动脉硬化组和颈总动脉斑块组血清LP、HbA1c均高于颈总动脉正常组(P<0.05)。颈总动脉斑块组TC高于颈总动脉正常组[(4.32±1.10)vs(3.69±0.67) mmol/L,P<0.05]。Pearson相关性分析示,CIMT与hsC-RP、Hcy呈正相关(r=0.560、0.452,P均<0.01)。Logistic回归分析示,CIMT与hsC-RP、Hcy独立相关(OR=1.501、1.523,P均<0.01)。 结论 老年T2DM合并高血压患者血清hsC-RP、Hcy水平不仅是颈动脉硬化的独立相关因素,且与其动脉硬化斑块的稳定性相关。

  【关键词】 老年;糖尿病,2型;颈动脉粥样硬化;同型半胱氨酸

  【Abstract】 Objective To investigate the relationship of hypersensitive C reactive protein with carotid atherosclerosis and serum calcium and phosphorus in elderly patients with type 2 diabetes mellitus plus hypertension and increased homocysteine. Methods A total of 105 subjects were enrolled. Carotid intima-media thickness(CIMT)was determined by doppler ultrasound. All the participants were divided into three groups: control group (n=30, IMT<0.9 mm), common carotid sclerosis group (n=30,0.9 mm≤IMT<1.2 mm) and common carotid plaque group (n=45,IMT≥1.2 mm). Common carotid plaque group was again divided into stable plaque subgroup (n=20)and unstable plaque subgroup (n=25). Serum hypersensitive C reactive protein(hsC-RP), homocysteine(Hcy), calcium and phosphorus levels were detected. Logistic regression was used to evaluate the risk factors for IMT. Results The level of hsC-RP[(16.88±5.31) vs (11.56±5.52) mg/L], Hcy[(19.47±10.18) vs (14.93±3.41) μmol/L] and CIMT[(0.98±0.09) vs (0.93±0.05) mm] were significantly higher in common carotid plaque group than in common carotid sclerosis group(P<0.05). There were no significant difference in Ca2+[(2.24±0.3) vs(2.26 ±0.16) mmol/L]、P3-[(1.19±0.25) vs (1.13±1.14) mmol/L] between the two groups(P>0.05).The levels of lipoproteins (LP) and hemoglobin A1c (HbA1c) were significantly higher in common carotid sclerosis group and common carotid plaque group than in the control group(P<0.05).The TC was higher in common carotid plaque group than in the control group[(4.32±1.10)vs(3.69±0.67),P<0.05].Pearson correlation analysis showed than CIMT was positively associated with hsC-RP and Hcy (r=0.560, 0.452, P<0.01). Logistic regression analysis showed that IMT is independently associated with hsC-RP and Hcy(OR=1.501、1.523, P<0.01). Conclusion The levels of serum hsC-RP and Hcy were not only independent risk factors for carotid artery atherosclerosis but also related to the stability of atherosclerosis plaque in the patients with type 2 diabetes mellitus with hypertension.

  【Key words】 Elderly; Diabetes mellitus, type 2;Carotid artery atherosclerosis; Homocysteine

上一篇:血清C肽水平变化与2型糖尿病微血管病变的相关性研究 下一篇:2型糖尿病患者血清PLGF水平与颈动脉粥样硬化的相关性研究

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