2型糖尿病合并脑梗死患者颈动脉、血脂及血浆纤维蛋白原的变化

目的 探讨2型糖球病合并脑梗死（DC1）患者颈动脉、血脂及血浆纤维蛋白原（Fg）的变化。方法 对58例DC1患者（DC1组）及36例非糖尿病不合并脑梗死患者（对照组）进行颈动脉超声检测，观察颈动脉粥样硬化斑块的部位、数目、性质和颈动脉内径；并作血糖、血脂和Fg含量测定。结果 DC1组颈动脉粥样硬化斑块的发生率（79．3％）、颈总动脉（CCA）内膜-中层厚度（1MT）和CCA内径与对照组比较差异有极显著性（均P〈0．01），斑块发生部化以CCA分叉处及颈内动脉（ICA）入口和起始处最多（86．0％）；以软斑为主（62．5％）。脑梗死部位与出现斑块的颈动脉存在同侧相关性（P〈0．01）。DC1组血糖、总胆固醇、三酰甘油及Fg较对照组显著增高（均P〈0．01）。结论 DC1患者大多有颈动脉粥样硬化及血脂、血糖、Fg水平异常，对糖尿病患者颈动脉粥样硬化斑块和血脂、血糖等异常进行早期干预，对预防脑梗死的发生有重要临床意义。

Changes of carotid, lipidemia and fibrinogen in patients with type 2 diabetes mellitus complicated with cerebral infarction

Objective To investigate the changes of carotid, lipidemia and fibrinogen in type 2 diabetes mellitus patients complicated with cerebral infarction (DCI). Methods 58 cases of DCI (DCI group) were enrolled in this study, and 36 cases of cerebral infarction without diabetes mellitus served as control group. The location, number and nature of carotid atherosclerotic plaque and inner diameter of carotid artery were assessed by Doppler ultrasonography in all the patients, as well as blood lipid, blood glucose and fibrinogen were evaluated. Results In DCI group, the rate of carotid atherosclerotic plaque was 79.3%, the IMT and inner diameter of common carotid artery in DCI group were significantly different from control group (all (P<)0.01). The atherosclerotic plaques detected in bifurcation of common carotid artery and origin point of internal carotid artery were more common (86.0%), and most of them (62.5%) were soft plaques. A correlation was found between the location of carotid atherosclerotic plaque and the side of cerebral infarction ((P<)0.01). The levels of blood glucose, total cholesterol, triglyceride and fibrinogen were obviously higher than those of control group (all (P<)0.01). Conclusions Atherosclerotic plaque and metabolic disorders included blood glucose, blood lipid and fibrinogen are the common phenomena in the patients with DM complicated with cerebral infarction. Early intervention of carotid atherosclerotic plaque and metabolic disorders in patients with DM is important for prevention of cerebral infarction.