Chlumský J, Charvát J, Hájek P
Interní klinika Fakultní nemocnice Motol a 2. Lékarské fakulty UK, Praha.
Vnitr Lek. 2001 Nov;47(11):744-6.
Neurological complications of patients during cardiac operations are closely associated with affections of the carotid arteries. The relationship of diabetes to these findings was not investigated so far. During the period between July 1 and Dec. 31 2000 the authors examined sonographically 127 patients indicated for aortocoronary bypass on account of affection of three arteries. Diabetes mellitus type 2 was present in 44 patients. A significant stenosis was detected in 4 (5%) without diabetes and in 5 (11%) patients with diabetes (p < 0.05), moreover in two patients with diabetes complete obstruction of the inner carotid was found. An insignificant stenosis (up to 70% was found in 3 (3%) of the patients without diabetes and in 3 (7%) patients with diabetes (p < 0.05). The thickness of the intima and media (IMT) was in patients with diabetes insignificantly greater (0.76 vs. 0.89 mm, NS). The mean index of echogenicity of plaques was in diabetic patients also insignificantly greater (2.1 vs. 2.9 NS). Atherosclerotic plaques greater than 2 mm were more frequent in diabetics (7.8% vs. 8 (18%), p < 0.05). A significantly more frequent finding of carotid stenosis or larger plaques was proved in patients with a history of CMP. Sonographic findings on the vertebral arteries were not associated with the presence of diabetes.
Carotid sonography in patients of three arteries reveals in diabetic patients and in those with a history of CMP more frequent significant stenosis and the presence of major atherosclerotic plaques.
心脏手术患者的神经并发症与颈动脉病变密切相关。迄今为止,尚未研究糖尿病与这些发现之间的关系。在2000年7月1日至12月31日期间,作者对127例因三支动脉病变而接受主动脉冠状动脉搭桥手术的患者进行了超声检查。44例患者患有2型糖尿病。无糖尿病患者中有4例(5%)检测到明显狭窄,糖尿病患者中有5例(11%)检测到明显狭窄(p<0.05),此外,在2例糖尿病患者中发现颈内动脉完全阻塞。无糖尿病患者中有3例(3%)、糖尿病患者中有3例(7%)发现轻度狭窄(高达70%)(p<0.05)。糖尿病患者的内膜和中膜厚度(IMT)略厚(0.76对0.89mm,无显著性差异)。糖尿病患者斑块的平均回声指数也略高(2.1对2.9,无显著性差异)。糖尿病患者中大于2mm的动脉粥样硬化斑块更为常见(7.8%对8(18%),p<0.05)。有CMP病史的患者中,颈动脉狭窄或较大斑块的发现明显更频繁。椎动脉的超声检查结果与糖尿病的存在无关。
对三支动脉病变患者进行颈动脉超声检查发现,糖尿病患者和有CMP病史的患者中,明显狭窄和主要动脉粥样硬化斑块的出现更为频繁。