糖化血红蛋白与老年男性颈动脉内膜厚度的相关性研究

目的探讨糖化血红蛋白（HbAlc）对老年男性颈动脉硬化的预测价值。方法共50例HbAlc≥6．0％的老年男性患者（A组）和48例HbAlc〈6．0％的老年男性患者（B组）纳入本研究，采集其空腹及餐后2h血标本测定空腹血糖、餐后2h血糖、血脂，使用动态血压检测仪和彩色多普勒测量受检者的血压和颈动脉内膜中层厚度（CIMT）。结果 （1）A组空腹血糖、餐后2h血糖、糖尿病病史、三酰甘油、24h收缩压、白昼收缩压、夜间收缩压均高于B组（P〈0．05）；（2）B组左侧CIMT为（0．98±0．18）mm、右侧为（0．92±0．18）mm，内膜增厚率为62．5％，斑块检出率为37．5％；A组左侧CIMT为（1．22±0．18）mm、右侧为（1．16±0．19）mm，内膜增厚率为94％，斑块检出率为64％。组间差异有统计学意义（P〈0．01）。（3）多元线性回归分析结果显示，老年男性的CIMT与HbAlc、吸烟史、餐后2h血糖、24h收缩压、糖尿病病史相关。结论HbAlc是老年男性颈动脉硬化的重要预测因子。

Relationship between glycated hemoglobin and carotid intimal medial thickness in the elderly male patients

Objective To discuss the value of glycated hemoglobin（HbAlc） in predicting carotid atherosclerosis in the elderly male population. Methods Fifty elderly male patients with HbAlc≥ 6. 0% （ group A） and 48 elderly men with HbAlc〈6.0% （group B）were enrolled, and the levels of fasting plasma glucose（ FPG）, 2 h post load plasma glucose （2hPG） and blood lipid were measured.All the patients＇ blood pressure and CIMT were detected by ambulatory blood pres- sure monitoring and color Doppler apparatus respectively. Results （ 1 ） The levels of FPG, 2hPG, history of diabetes, triglyceride, 24 h systolic blood pressure, day systolic blood pressure and night systolic blood pressure were significantly higher in group A than those in group B（P〈0. 05）.（2）The level of CIMT in group B was（0. 98±0. 18） mm on the left and （0. 92±0. 18）mm on the right, mid the prevalence of intimal thickening and the incidence of plaque were 62. 5% and 37. 5% respectively, compared with （ 1.22±0. 18）mm on the left, （ 1.16±0. 19）mm on the right,94% on the prevalence of intimal thickening and 64% on the incidence of plaque in group A （P〈0. 01 ）. （3）Regression analysis showed that HbA1 c, smoking ,2hPG, 24 h systolic blood pressure and history of diabetes were strongly associated with CIMT in the elderly men. Conclusions The value of HbAlc is strongly associated with CIMT in the elderly men, which might have significant effects on carotid atherosclerosis.