高敏C反应蛋白与糖尿病患者动脉粥样硬化的相关性分析

目的了解炎性反应标志物超敏C反应蛋白(hypersensitivity C-reaction protein,hsCRP)与糖尿病患者中颈动脉粥样硬化发生之间的关系,加深对糖尿病导致外周血管病变的认识。方法对入选的150例糖尿病患者进行颈动脉超声检查,测量颈总动脉内中膜厚度(IMT),观察有无斑块形成,以判定是否出现颈动脉粥样硬化,并进行血清hsCRP定量检测。对血清hsCRP与颈动脉粥样硬化、颈总动脉内中膜增厚、及斑块形成进行相关性分析。结果①2型糖尿病患者中合并颈动脉粥样硬化者血清hsCRP异常比例明显高于无颈动脉病变者(P<0.01),颈总动脉内中膜增厚者血清hsCRP异常率与正常者相比差异有统计学意义(P=0.000),与颈动脉斑块形成者比较血清hsCRP异常率差异也有统计学意义(P=0.02);②吸烟与非吸烟患者血清hsCRP异常率差异无统计学意义;③伴有高血压者血清hsCRP异常率与无高血压者的差异有统计学意义(P<0.05);④按颈动脉IMT厚度将受试者分为正常和异常2组进行Logistic回归分析发现:年龄(OR=1.023,P=0.00)、hsCRP(OR=1.012,P=0.00)、LDL-C(OR=2.553,P=0.00)、HDL-C(OR=0.146,P=0.00)、高血压(OR=3.465,P=0.00)和吸烟史(OR=2.276,P=0.00)与颈动脉粥样硬化相关。结论血清hsCRP含量与糖尿病颈动脉粥样硬化的发生有一定相关性,合并颈动脉粥样硬化尤其是伴有颈动脉斑块患者的血清hsCRP异常率显著高于无颈动脉病变患者,高血压对血清hsCRP与颈动脉粥样硬化之间的相关性可能产生影响。

The Relationship between Hypersensitivity C-Reaction Protein and Artherosclerosis in Patients with Type 2 Diabetes Mellitus

Objective To explore the relationship between inflammation marker hypersensitivity C-Reaction Protein(hsCRP) and carotid artherosclerosis in patients with type 2 diabetes mellitus(DM), to deepen the cognition of peripheral vascular disease(PVD) induced by diabetes mellitus. Methods Carotid artery ultrasonometry intra-tunica media thickness(IMT) was tested in 150 type 2 diabetic patients to observe if there were plaques or not. Serum hsCRP quantitative estimation was analyzed. Statistic methods were used in interrelationship analyze of the serum hsCRP, carotid artherosclerosis and plaques formation. Results 1 Serum hsCRP abnormal proportion in diabetic patients with carotid artherosclerosis was significantly higher than diabetic patients without it(P<0.01). Those serum hsCRP abnormal proportion in diabetic patients with IMT and plaques was significantly higher than that of normal control group(P=0.000 and P=0.02); 2 There was no significant differences in serum hsCRP abnormal proportion in smoker-patients and non-smoker patients; 3 Serum hsCRP abnormal proportion in hypertension patients was significantly higher than that of non-hypertension patients(P<0.05); 4 After Logistic regression, we found that age(OR=1.023, P=0.00), hsCRP(OR=1.012, P=0.00), LDL-C(OR=2.553, P=0.00), HDL-C(OR=0.146, P=0.00), hypertension(OR=3.465, P=0.00) and smoking history(OR=2.276, P=0.00) were related with carotid artherosclerosis. Conclusion There was a certain relationship between the level of serum hsCRP and carotid artherosclerosis in patients with type 2 diabetes mellitus. Serum hsCRP abnormal proportion in type 2 diabetes mellitus with carotid artherosclerosis especially with carotid plaques was significantly higher than that of patients without carotid pathology. Hypertension may have an effort on the relationship of serum hsCRP and carotid artherosclerosis.