目的 探讨初发2型糖尿病患者颈动脉内膜中层厚度(IMT)的影响因素,以及阿托伐他汀长期治疗逆转IMT的效果.方法 将116例初发2型糖尿病合并颈动脉粥样硬化患者分为常规治疗组(对照组)和阿托伐他汀治疗组,随访观察1年,测定治疗前后患者体质量指数、血压、血脂、糖化血红蛋白(HbA1c)、空腹及餐后2h血糖、血清基质金属蛋白酶-9(MMP-9)及IMT.结果 (1)经过1年的干预治疗后,治疗组的MMP-9及IMT显著低于对照组(P<0.05);(2)△IMT与年龄、治疗后TC及MMP-9的下降值显著相关(β分别为0.008、0.051和0.092,P<0.05).结论 2型糖尿病患者IMT主要受年龄、TC、MMP-9的影响;阿托伐他汀可通过调脂、降低MMP-9水平逆转IMT.%Objective To investigate the influencing factors of the carotid intima medial thickness ( IMT ) and whether long-term atorastatin treatment would ameliorate IMT in newly diagnosed type 2 diabetic patients complicated with carotid atherosclerosis. Methods One hundred and sixteen cases of newly diagnosed type 2 diabetic patients with carotid atheroclerosis were divided randomly into 2 groups of atorvastatin treatment and conventional treatment group. All patients were followed up 1 year. The levels of body mass index( BMI ), blood pressure, lipids, hemoglobin Alc( HbAlc ), fasting blood glucose ( FBG ), 2 hour postpradial glucose ( 2hPG ),matrix meralloproteinases-9 ( MMP-9 ) and IMT were measured before and after treatment. Results ( 1 ) After 1 year treatment, the levels of IMT and serum MMP-9 in atorvastatin group were significantly decreased than those of conventional treatment group( P ＜ 0.05 ). ( 2 ) In multivariate regression, the △IMT was significantly associated with age, the change of TC and MMP-9 after treatment( β= 0. 008、0. 051,0. 092 respectively, P ＜ 0.05 ). Conclusion The IMT appears to be closely related to the age, TC and MMP-9 in the patients with type 2 DM, furthermore, the long-term atrovastatin treatment could ameliorate the IMT in type 2 DM which may be associated with the decreasing of MMP-9 and lipids.
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