超高龄2型糖尿病患者并发动脉粥样硬化的影响因素分析

目的探讨超高年龄2型糖尿病患者（T2DM）并发动脉粥样硬化（AS）的影响因素。方法选择2010年1月～2012年10月于海军总医院住院治疗的242例超高年龄老年T2DM患者，按有无AS分为动脉粥样硬化组（AS组）及非动脉粥样硬化组（NAS组），比较两组患者性别、年龄、吸烟史、糖尿病病程、体重指数（BMI）、空腹血糖（FBG）、餐后血糖（PBG）、胰岛素抵抗指数（HOMA-IR）、收缩压（SBP）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL～C）、脂联素（APN）、超敏C反应蛋白（hs—CRP）水平差异。对阳性因素采用Logistic回归分析T2DM并发AS的相关影响因素。结果超高年龄老年T2DM患者AS发生率为54．5％，AS组同NAS组患者吸烟史、糖尿病病程、BMI、PBG、FBG、HOMA—IR、TC、LDL—C、HDL—C、APN、hs—CRP水平差异有统计学意义（P〈0．05）。Logistic回归分析显示，吸烟、HOMA—IR、SBP、TC、hs—CRP是超高龄老年T2DM患者并发AS的独立危险因素，APN是超高龄老年T2DM患者并发AS的保护性因素（P〈0．05）。结论超高年龄老年T2DM患者并发AS的危险因素较多，在控制血糖过程中要注意对危险因素的控制，减少大血管病变的发生。

Clinical analysis of influencing factor for angiosclerosis in super-aged patients with type 2 diabetes mellitus

Objective To investigate the influencing factor of type 2 diabetes mellitus （T2DM） combined with angiosclerosis （AS） in super-aged patients. Methods 242 cases of super-aged patients with T2DM treated in Navy General Hospital from January 2010 to October 2012 were selected and divided into AS group and NAS group according to combined with AS or not. Then gender, age, smoking history, course of diabetes mellitus, body mass index （BMI）, fasting blood glucose （FBG）, postprandial blood glucose （PBG）, insulin resistance （HOMA-IR）, systolic blood pressure （SBP）, total cholesterol （TC）, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, adip0nectin （APN） and high sensitive C- reactive protein （hs-CRP） were contrasted between AS groups and NAS group, and positive factors were analyzed with Logistic regression analysis to find risk factor of T2DM combined with AS. Re- suits Incidence rate of AS in super-aged patients with T2DM was 54.5%. The differences of smoking, course of dia- betes mellitus, BMI and level of PBG, FBG, HOMA-IR, TC, LDL-C, HDL-C, APN and hs-CRP between AS group and NAS group were significant （P 〈 0.05）. Logistic regression analysis showed that smoking, level of HOMA-IR, SBP, TC, and hs-CRP were risk factors and level of APN was protection factor of T2DM combined with AS in superaged patients. Conclusion There are many risk factors of T2DM combined with AS in super-aged patients, attentions should be paid for risk factor in process of blood sugar controlling, in order to decrease the incidence of macroangiopathy.