https://scholars.lib.ntu.edu.tw/handle/123456789/188179
Title: | 糖尿病對頸動脈構造及功能之影響 | Authors: | 蘇大成 | Issue Date: | 2002 | Publisher: | 臺北市:國立臺灣大學醫學院內科 | Abstract: | 研究背景:糖尿病是冠狀動脈心臟病及腦 中風之主要危險因子。近年隨著經濟發展 生活富裕,國人常有營養過度及肥胖之趨 勢,國人糖尿病的盛行率有逐年上昇之 勢,糖尿病對國人健康的威脅絕不可忽 視。材料及方法:本研究藉由具人群代表 性的社區心臟血管研究--金山社區長期 追蹤的族群中,使用病例對照組於 1994-1995 年金山社區第三次追蹤的世代 中,空腹血糖超過126mg/dl 者,或是有 糖尿病病史正在接受治療者,其年齡現在 在45-65 歲者共192 位,選為病例組,而 經由性別及年齡配對後,選出對照組192 位,總共384 位納入此次研究通知對象。 我們用高解析度的B 模式的頸動脈超音波 來測量,並以總頸動脈最厚的內皮+中皮 厚度(IMT),及顱外頸動脈硬化塊分數, 來表示顱外頸動脈硬化的程度及頸動脈 血管直徑大小在收縮期及舒張期的變化 來看頸動脈彈性。。結果:於2001 年共 有108 位有糖尿病病史及135 位對照組參 與頸動脈硬化及彈性之檢查。我們發現糖 尿病患者頸動壁脈增厚及動脈硬化塊的 嚴重程度與對照組並無顯著差異,但頸動 脈血管彈性則明顯變差。即使用多變項迴 歸分析來檢驗頸動脈血管彈性指標,我們 用擴張參數(distensibility coefficient, DC) 來表達時,發現糖尿病病史、年齡、收縮 壓、平均動脈壓、脈壓差皆是擴張參數的 重要影響因子。結論:糖尿病明顯的影響 頸動脈的動脈彈性。我們的發現更加強了 糖尿病在動脈硬化的病理形成上扮演一 主要的角色的理論。 Backgrounds :With the current trend of aging population in Taiwan, it is urgent to pay more attention to early detection of atherosclerosis to prevent the atherosclerotic diseases. Diabetes mellitus (DM) is one of the well- known and major risk factors for coronary and carotid arteries atherosclerosis. Material and Methods : One hundred and eight DM patients and 135 non-DM control subjects from the Chin-Shan Community Cardiovascular Cohort participated in this study in 2001. The carotid atherosclerosis was measured by high-resolution B-mode ultrasonography and expressed as maximal intima-media thickness of the common carotid artery (CA), internal CA, carotid bulb, and extracranial CA plaque score. The carotid arterial compliance was measured using common CA diameter changes, and was defined as Distensibility Coefficient (DC)= (2(systolic diameter - diastolic diameter)/ systolic diameter)/(systolic BP-diastolic BP). Results of measurements of carotid atherosclerosis showed no significant difference between DM and control. However, DC decreased in DM group while comparing with control. Further analysis using multivariate lineal regression model revealed that DM, age, blood pressure components (SBP, DBP, MAP, and PP) are important determinants of DC. Conclusions : Patients with DM decreased carotid arterial distensibility though no significant difference in carotid atherosclerosis. Our findings support that DM is important in the pathogenesis of atherosclerosis in middle-aged population. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/23577 | Other Identifiers: | 902320B002178 | Rights: | 國立臺灣大學醫學院內科 |
Appears in Collections: | 醫學系 |
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