2型糖尿病合并原发性高血压病患者AASI与颈动脉粥样硬化的相关性分析

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摘要目的探讨2型糖尿病合并原发性高血压患者动态动脉硬化指数（AASI）的变化，分析其与颈动脉粥样硬化的相关性。方法选取2015年1月～2017年1月我院内分泌科收治的明确诊断且未经治疗的180例2型糖尿病合并原发性高血压患者作为研究对象，根据颈动脉内中膜厚度（IMT）分成IMT正常组（n＝51）、IMT增厚组（n＝69）、斑块形成组（n＝60）。所有患者均检测生化指标、糖化血红蛋白、空腹胰岛素、颈动脉彩超、24 h动态血压等指标，比较三组患者的AASI变化，探讨AASI与颈动脉粥样硬化的相关性。结果IMT增厚组、斑块形成组患者的SBP、DBP、TG、LDL-C、FPG、HbA1c、FINS、HOMA-IR、UA、Cystatin C 明显高于 IMT 正常组，差异有统计学意义（P＜0.01）。斑块形成组患者的 SBP、DBP、TG、LDL-C、FPG、HbA1c、FINS、HOMA-IR、UA、Cystatin C 均明显高于 IMT 增厚组，差异有统计学意义（P＜0.01）。IMT增厚组、斑块形成组患者的AASI、IMT、RI水平均明显高于IMT正常组，SV、DV水平明显低于IMT正常组，差异有统计学意义（P＜0.01）。斑块形成组患者的AASI、IMT、RI明显高于IMT增厚组，SV、DV明显低于IMT增厚组，差异有统计学意义（P＜0.01）。单因素相关分析结果提示，IMT与TG、LDL-C、SBP、DBP、PP、FPG、UA、Cystatin C、AASI、RI、年龄均呈明显正相关（r＝0.482，0571，0.667，0.509，0.603，0.711，0.386，0.504，0.727，0.623，0.472；P＜0.05），与 SV、DV 呈明显负相关（r＝-0.567，-0.611；P＜0.01）。多元逐步回归分析结果提示：颈动脉 IMT 水平与 PP、AASI、FPG、UA、LDL-C 独立相关（β＝1.229，1.442，0.887，1.501，1.884；P＜0.05）。结论2 型糖尿病合并原发性高血压患者的AASI水平随着IMT的升高逐渐升高，其水平与颈动脉IMT水平独立相关，可作为颈动脉粥样硬化的预测因子。

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	刘桑燕
	杨阳
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	李烨
	王艳

关键词 ： 2型糖尿病, 原发性高血压, 动态动脉硬化指数, 颈动脉内中膜厚度, 相关性

Abstract：ObjectiveTo investigate the changes of ambulatory arterial stiffness index (AASI)in the type 2 diabetes mellitus and hypertension,and to analysis the correlation between ambulatory arterial stiffness index and carotid artery atherosclerosis.MethodsThere were 180 patients with type 2 diabetes mellitus and hypertension who were treated in the department of endocrinology in our hospital from January 2015 to January 2017 were selected as subjects for the study.They were divided into there groups(the normal carotid intima-media group,the thickened carotid intima-media group and the plaque formation group)according to carotid intima-media (IMT)thickness.All the patients were tested for biochemical indicators,glycosylated hemoglobin,fasting insulin,carotid artery color ultrasound and 24 hours dynamic blood pressure.The AASI changes of patients in three groups were compared,AASI and the correlation of carotid atherosclerosis were investigated.ResultThe levels of SBP,DBP,TG,LDL-C,FPG,HbA1c,FINS,HOMA-IR,UA and Cystatin C in the thickened carotid intima-media group and the plaque formation group were significantly higher than those in the normal carotid intima-media group,and the differences were statistically significant(P＜0.01).The levels of SBP,DBP,TG,LDL-C,FPG,HbA1c,FINS,HOMA-IR,UA and Cystatin C in the plaque formation group were signifi-cantly higher than those in the thickened carotid intima-media group,and the differences were statistically significant(P＜0.01).The levels of AASI,IMT and RI in the thickened carotid intima-media group and the plaque formation group were significantly higher than those in the normal carotid intima-media group,while the levels of SV and DV were significantly lower than those in the normal carotid intima-media group,and the differences were statistically significant(P＜0.01).The levels of AASI,IMT and RI in the plaque formation group were significantly higher than those in the thickened carotid intima-media group,while the levels of SV and DV were significantly lower than those in the thickened carotid intima-media group,and the differences were statistically significant(P＜0.01).Single factor correlation analysis results showed that the levels of IMT were positive correlated with TG,LDL-C,SBP,DBP,PP,FPG,UA,Cystatin C,AASI,RI and age(r＝0.482,0571,0.667,0.509,0.603,0.711,0.386,0.504,0.727,0.623,0.472;P＜0.05),while the levels of IMT were negatively correlated with SV,DV(r＝-0.567,-0.611;P＜0.01).Multiple stepwise regression analysis revealed that the levels of IMT were independent of PP,AASI,FPG,UA,LDL-C(β＝1.229,1.442,0.887,1.501,1.884;P＜0.05).Conclusions With the IMT increased,the levels of AASI are significantly increased and it is closely correlated with carotid artery intimamedia thickness,which reveale the AASI may be a predictive factor of the carotid atherosclerosis.

Key words： Type 2 diabetes mellitus Hypertension Ambulatory arterial stiffness index Carotid artery Intima-Media thickness Correlation

作者简介: 刘桑燕（1973-），女，本科，副主任医师，研究方向：糖尿病及其并发症

引用本文:

刘桑燕;杨阳;涂振兴;李烨;王艳. 2型糖尿病合并原发性高血压病患者AASI与颈动脉粥样硬化的相关性分析[J]. 中国当代医药, 2017, 24(32): 35-38转42.
LIU Sang-yan;YANG Yang;TU Zhen-xing;LI Ye;WANG Yan. Correlation between ambulatory arterial stiffness index and carotid artery atherosclerosis in patients with type 2 diabetes mellitus and hypertension. 中国当代医药, 2017, 24(32): 35-38转42.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I32/35

[5]	孙宁玲.2004年中国高血压防治指南修订版的解读[J].高血压杂志，2005，13（6）：378-379.
[7]	王显利，牟建军，廉秋芳，等.高血压患者动态脉压相关指数及高敏C反应蛋白与颈动脉粥样硬化的关系[J].西安交通大学学报（医学版），2013，34（2）：194-197.
[8]	郑琴，黄波，孙燕淑，等.动态动脉硬化指数与老年冠心病的相关性研究[J].中华老年心脑血管病杂志，2016，18（5）：470-473.
[1]	Tebbe U，Bramlage P，Thoenes M，et al.Prevalence of microalbuminuria and it s associated cardiovascular risk：German and Swiss results of the recent global i-SEARCH survey[J].Swiss Med Wkly，2009，22（33）：473-480.
[2]	Aznaouridis K，Vlachopoulos C，Protogerou A，et al.Ambulatory systolic-diastolic pressure regression index as a predictor of clinical events：a meta-analysis of longitudinal studies[J].Stroke，2012，43（3）：733-739.
[3]	Kollias A，Stergiou GS，Dolan E，et al.Ambulatory arterial stiffness index：a systematic review and Meta-analysis[J].Atherosclerosis，2012，224（2）：291-301.
[4]	Xu TY，Li Y，Wang YQ，et al.Association of stroke with ambulatory arterial stiffness index （AASI） in hypertensive patients[J].Clin Exp Hypertens，2011，33（5）：304-308.
[6]	Leoncini G，Ratto E，Viazzi F，et al.Increased ambulatory arterial stiffness index is associated with target organ damage in primary hypertension[J].Hypertension，2006，48（3）：397-403.
[9]	陈云，袁如玉，阎哲慧，等.动态动脉硬化指数对原发性高血压患者冠心病的预测价值[J].天津医科大学学报，2013，19（6）：468-470.
[10]	Garcia A，Gomez MA，Recio JI，et al.Relationship between ambulatory arterial stiffness index and subclinical target organ damage in hypertensive patients[J].Hypertens Res，2011，34（2）：180-186.
[11]	周成礼，房袁媛.动态动脉硬化指数和颈动脉超声相关参数与冠状动脉粥样硬化性心脏病的关系[J].临床超声医学杂志，2017，19（7）：444-448.
[12]	张维波，傅强，陈成，等.2型糖尿病患者动态动脉硬化指数与颈动脉硬化及其危险因素关系研究[J].中国现代医药杂志，2011，3（10）：23-26
[13]	Wang C，Zhang J，Li CC，et al.The ambulatory arterial stiffness index and target-organ damage in Chinese patients with chronic kidney disease[J].BMC Nephrol，2013，14（1）：257.
[14]	Gomez MA，Recio JI，Patino MC，et al.Ambulatory arterial stiffness indices and target organ damage in hypertension[J].BMC Cardiovasc Disord，2012，12（1）：1.
[15]	刘长萍，卞文明，彭开兵，等.血压晨峰、动态动脉硬化指数与颈动脉内膜中层厚度相关性分析[J].心血管康复医学杂志，2015，24（2）：136-139.