摘要
目的分析2型糖尿病患者颈动脉与下肢动脉粥样硬化的危险因素及其与冠状动脉疾病的相关性。方法1005例2型糖尿病患者接受颈动脉及下肢动脉超声检查，按病变程度分为0～4级，记录冠状动脉疾病相关病史。结果颈动脉与下肢动脉粥样硬化程度呈正相关。高血压（OR：1．8，95％CI：1．2—2．9）和冠状动脉疾病病史（OR：2．8，95％CI：1．6～5．0）是2级以上颈动脉硬化的独立危险因素；而HbA1c≥8％（OR：1．7，95％C1：1．2～2．6）和糖尿病视网膜病变（OR：1．7，95％C1：1．1～2．6）是2级以上下肢动脉硬化的独立危险因素。以颈动脉硬化2级、下肢动脉硬化2级和两者硬化均超过2级为切点，对冠状动脉疾病的阳性预测值分别为28．6％、28．5％和32．5％。结论颈动脉与下肢动脉粥样硬化程度呈等级相关。高血压患者易发生颈动脉硬化，而HbA1c≥8％患者易发生下肢动脉硬化。颈动脉及下肢动脉粥样硬化均与冠状动脉疾病相关，联合观察颈动脉及下肢动脉病变有助于筛查冠状动脉疾病。
Objective To analyze the risk factors of carotid artery and lower limb artery atherosclerosis and to explore their relationship to coronary disease. Methods Totally, 1 005 patients with type 2 diabetes received ultrasound scanning of bilateral carotid and lower limb arteries. Carotid artery atheroselerosis （CA） and lower limb artery atherosclerosis （LA） were classified into 0 to 4 grades. The coronary disease related history was recorded. Results The grade of CA was positively correlated with that of LA. CA and LA shared some risk factors including age, duration of diabetes, male gender, history of ischemic brain damage, and diabetic peripheral neuropathy. In addition, hypertension and coronary disease history were independent risk factors for CA≥grade 2, while HbA1c≥8% and diabetic retinopathy were independent risk factors for LA≥ grade 2. The positive predictive values of CA≥grade 2, LA≥grade 2 for screening coronary disease were 28.6% and 28.5%, it reached 32.5% while both sites≥grade 2. Conclusion Carotid artery atherosclerosis and lower limb artery atherosclerosis are positively correlated. Hypertension is closely related to carotid artery atherosclerosis while HbA1c≥8% is related to lower limb artery atherosclerosis. Atherosclerosis at both sites is correlated with coronary disease. Examining these peripheral arteries, more efficient in combination, seems to be a helpful way for screening coronary disease.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2009年第4期366-369,共4页
Chinese Journal of Endocrinology and Metabolism
基金
973重大基础研究项目（2006CB503903）
关键词
动脉硬化
冠状动脉疾病
糖尿病
2型
超声检查
多普勒
彩色
Atherosclerosis
Coronary disease
Diabetes mellitus,type 2
Uhrasonography,Doppler, color
