The Study Of ExtracranialCarotid Atherosclerosis In T2DM Associated With Cerebral Infarction

Objective: Type 2 diabetes mellitus (T2DM) has become the current global health problem, the incidence is an increasing tendency in our country. As a complication and major causes of death of diabetes, cerebral infarction is closely related with carotid atherosclerosis. This study evaluated the relationship between type 2 diabetes mellitus patients associated with cerebral infarction and extracranial carotid atherosclerosis by retrospective analysis, to provide prevention and treatment for clinical basis.Methods: A total of 146 cases who were admitted to 1st affiliated hospital of Shantou University Medical College between April 2008 to November 2009, According to CT or/and MRI scanning, these patients were divided into diabetes mellitus associated with cerebral infarction(DMCI) group (102 cases) and diabetes mellitus non-cerebral infarction(DMNCI)group (44 cases). The extracranial carotid arteries of the whole cases were examined by high-frequency color Doppler ultrasonography, the differences of age, sex, duration of diabetes, intima-media thickness of the carotid arteries, atherosclerotic plaque incidence, distribution, and characteristic of plaque between two groups were compared. Statistical analyses were carried out using an SPSS 17.0 statistical package program, unpaired student's t test was used for continuous data (two-tail) when comparing variables between the groups. A nonparametric test was used with skewed distribution of data. Percentage was used to describe enumeration count data, group comparison was analyzed by Chi-square test. Significance was assumed when the P value was less than 0.05.Results:1. Carotid arteries intima-media thickness of the diabetes mellitus associated with cerebral infarction group was significantly thicker than the diabetes mellitus non-cerebral infarction group.2. The incidence of carotid artery atherosclerosis plaque in the diabetes mellitus associated with cerebral infarction group was significantly higher than the diabetes mellitus non-cerebral infarction group.3. The distribution of carotid artery atherosclerosis plaque was different from diabetic patients associated with cerebral infarction group and the diabetes mellitus non-cerebral infarction group, but showed no significant differences.4. The proportion of the carotid artery unstable plaque in diabetes mellitus associated with cerebral infarction group patient is significantly higher than the diabetes mellitus non-cerebral infarction group.Conclusion:1. The occurrence of cerebral infarction in diabetes mellitus patients is closely related with extracranial carotid atherosclerosis, as the extracranial carotid artery plaque increased, the risk increased.2. The intima-media thickness was obviously thicker in the patient of diabetes mellitus associated with cerebral infarction, which can be one of the indicators to predict the occurrence of cerebral infarction in diabetes patients.3. Carotid bifurcation is the predilection site in carotid atherosclerotic plaque, which can be used as the focus monitoring window when examined by color Doppler ultrasonography.4. Regular dynamic monitoring carotid arteries with color Doppler ultrasonography in diabetes patients, will be helpful for early understanding the structure of the carotid artery and the plaque formation, etc. That is very important to predict the occurrence and prevention of ischemic cerebrovascular disease.