兰州大学机构库 >学院待认领
2型糖尿病脉搏波速度的变化及其影响因素分析
Alternative TitleChanges of Pulse Wave Velocity and its Influential Factors in Patients with Type 2 Diabetes
王晓玉
Thesis Advisor刘永铭
2009-05-25
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword2型糖尿病 脉搏波速度 动脉僵硬度 因素
Abstract目的 1. 探讨2型糖尿病患者PWV的变化;2. 分析PWV与传统心血管危险因素及2型糖尿病并发症的关系;3. 观察2型糖尿病患者强化降糖治疗对PWV的影响。 方法 选取2008年9月至2009年1月我院门诊及住院2型糖尿病患者48例,男30例,女18例,年龄42~87岁,平均年龄(64.5±13)岁,根据有无合发症及并发症分为6组,单纯糖尿病组20例(糖尿病1组)、糖尿病合并高血压和或冠心病例28例(糖尿病2组),UAER<20ug/min者28例(糖尿病3组),UAER≥20ug/min者20例(糖尿病4组),无眼底病变者26例(糖尿病5组),有眼底病变者22例(糖尿病6组),其中2型糖尿病组中糖化血红蛋白>10%者10例作为强化降糖治疗组,健康对照组22例,男12例,女10例,年龄40~84 岁,平均年龄(59±12.4)岁,均来自健康体检者。使用法国Artech-Medical公司生产的康普乐(Complior SP)来检测动脉PWV,包括颈-股动脉脉搏波速度(CF-PWV)、颈-桡动脉脉搏波速度(CR-PWV)、颈-足背动脉脉搏波速度(CD-PWV)。对强化降糖治疗组进行胰岛素泵强化降糖治疗,待血糖控制(空腹血糖降至5~7mmol/L,餐后血糖降至7~10 mmol/L)后,继续维持强化降糖治疗,稳定一周后再次进行PWV的检测。结果 1.健康对照组的三段动脉比较CR-PWV(10.419±1.548 m/s)高于CD-PWV(9.620±1.412 m/s)(P=0.046),CR-PWV(10.419±1.548 m/s)高于CF-PWV(9.482±1.178 m/s)(P=0.025)。2. 2型糖尿病PWV的变化(1).2型糖尿病组及其分组CF-PWV高于对照组(P均为0.000),糖尿病2组CF-PWV高于糖尿病1组 (P=0.000),糖尿病4组CF-PWV高于糖尿病3组 (P=0.001),糖尿病6组CF-PWV高于糖尿病5组(P=0.002);(2). 糖尿病2.4.6组CD-PWV均高于对照组(P=0.000、P=0.000、P=0.000)糖尿病1、3、5组CD-PWV与对照组差异无统计学意义(P=0.891、0.482、0.653) 。 (3). 2型糖尿病组CR-PWV与对照组差异无统计学意义(P=0.625); (4).2型糖尿病男性与女性PWV比较差异无统计学意义(P=0.753)。 3. CF-PWV与心血管危险因素相关性分析 CF-PWV与年龄、收缩压、脉压差、糖尿病病程成线性相关,Pearson相关系数r=0.567、0.379、0.503、0.435(P=0.000、0.001、0.000、0.003),与心率、舒张压、体重指数、腰臀比、吸烟指数、空腹血糖、餐后2h血糖及糖化血红蛋白无线性相关(P=0.235、0.475、0.805、0.282、0.580、0.449、0.776、0.831)。4.CF-PWV与糖尿病并发症的关系 CF-PWV与UAER成线性相关,Pearson相关系数r=0.449(P=0.003),CF-PWV与眼底病变成线性相关,Spearson相关系数r=0.319(P=0.031)。以年龄、收缩压、脉压差、糖尿病病程UAER、眼底病变为自变量,CF-PWV为因变量进行多元回归分析,多元回归分析显示年龄和UAER是CF-PWV的独立预测因素,回归方程为:PWV=4.868+0.116年龄+0.0059UAER。5. 强化降糖治疗对CF-PWV的影响 强化降糖治疗前后,CF-PWV、CR-PWV、CD-PWV差异均无统计学意义(P=0.123、0.608、0.906)。结论 1.2型糖尿病大动脉弹性减低,而外周动脉弹性减低不显著,伴有合并症和并发症时大动脉减低更显著,下肢动脉弹性亦减低。2.年龄、收缩压、脉压差、糖尿...
Other AbstractObjective To study the changes of pulse wave velocity(PWV)and its influential factors in the patients with Type 2 Diabetes. To observe the changes of PWV of diabetic patients treated by insulin pump.Methods Between September 2008 and January 2009,48 patients were consecutively enrolled in this study. Ages ranged from 42 to 87 years(mean,64.5±13 years),with 30 male and 18 female patients. According to the different complications, diabetic patients were divided into six groups: group 1 without any complications(n=20), group 2 with hypertension and or coronary heart disease(n=28),group 3 with urinary albumin excretion rate(UAER)<20ug/min(n=28), group 4 with UAER≥20ug/min(n=20), group 5 without diabetic retinopathy (n=26),and group 6 with retinopathy (n=22).Meanwhile,22 healthy people were recruited as control group.Ages ranged from 40 to 84 years(mean,59±12.4 years),with 12 male and 10 female. Automatic PWV measuring system was applied to examine carotid-femoral PWV (CF-PWV)、carotid-radial PWV (CR-PWV) and carotid-dorsum of foot PWV(CD-PWV),which reflect central elastic large arterial and peripheral muscular medium sized arterial elasticity.Group 5 was treated by insulin pump until fasting blood glucose lowering to 5~7mmol/L, postprandial blood glucose dropping to 7~10mmol/L and maintaining the level for one week.PWV was examined once before and after the treatment.Results Compared with the control group, CF-PWV of all the diabetic patients with or without complications significantly increased(P<0.05) ,CD-PWV of the patients with complications showed statistical significance(P<0.05).The four factors hypertension,coronary heart disease, urinary albumin excretion rate(UAER) and diabetic retinopathy could significantly influence the CF-PWV of the patients with Type 2 Diabetes(P<0.05).The CD-PWV of patients with diabetic retinopathy was higher than that of patients without retinopathy.Our study didn't demonstrate any statistical significance of CR-PWV among the groups.CF-PWV significantly correlated with age, systolic blood pressure,pulse pressure ,duration of diabete,UAER and diabetic retinopathy(r=0.57、0.38、0.51、0.44、0.449、0.319; P<0.05 respectively). Multiple regression analysis demonstrated an independent association between PWV and age (P<0.05), UAER (P<0.05).There gression equation was: CF-PWV=4.868+0.116Age+0.0059UAER.The treatment of insulin pump didn’t produce significant influence to PWV of group 5. Conclusion Central elastic l...
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/224271
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
王晓玉. 2型糖尿病脉搏波速度的变化及其影响因素分析[D]. 兰州. 兰州大学,2009.
Files in This Item:
There are no files associated with this item.
Related Services
Recommend this item
Bookmark
Usage statistics
Export to Endnote
Altmetrics Score
Google Scholar
Similar articles in Google Scholar
[王晓玉]'s Articles
Baidu academic
Similar articles in Baidu academic
[王晓玉]'s Articles
Bing Scholar
Similar articles in Bing Scholar
[王晓玉]'s Articles
Terms of Use
No data!
Social Bookmark/Share
No comment.
Items in the repository are protected by copyright, with all rights reserved, unless otherwise indicated.