中文摘要：

目的探讨血压及血糖水平与原发性高血压合并糖尿病患者颈动脉粥样硬化的关系。方法将同时患有糖尿病和原发性高血压670例年龄〉60岁的患者，按照其收缩压及糖化血红蛋白（HbAlc）水平进行分组，将患者根据收缩压分组：血压严格控制组（血压〈130mmHg），血压一般控制组（血压130～139mmHg），血压未控制组（血压≥140mmHg）；根据其HbAlC水平分为血糖严格控制组（HbAlC〈6．5％），血糖一般控制组（HbAlc=6．5％～7．5％），血糖未控制组（HbAlc≥7．5％）。同时对每位患者进行颈动脉超声检查，记录颈动脉内中膜层的厚度。结果多因素线性回归分析显示，收缩压（β=0．215，P=0．002）和HbAlc（13=0．149，P=0．031）与颈动脉内中膜厚度呈正相关，而高密度脂蛋白胆固醇（β=0．196，P=0．002）与颈动脉内中膜厚度负相关。收缩压≥140mmHg（OR=1．473，95％CI 1．044—2．078P=0．027），HbAlc≥7．5％（OR=1．445，95％CI1．031～2．027，P=0．033），总胆固醇（OR=1．014，95％CI 1．004—1．024，P=0．012）为颈动脉粥样斑块形成的危险因素；而高密度脂蛋白胆固醇（OR=0．895，95％C10．805—0．994，P=0．019）为其保护性因素。结论血压、血糖水平是颈动脉粥样硬化及斑块形成的危险因素之一。

英文摘要：

Objective To explore the association between blood pressure and blood glucose levels and carotid atherosclerosis in elderly patients with essential hypertension and type 2 diabetes mellitus （T2DM）. Methods A total of 670 patients aged 60 years or over with hypertension and T2DM were recruited and categorized by their systolic blood pressure （SBP） ： tight control, 〈 130 mm Hg, usual control, 130- 139 mm Hg, or uncontrolled, ≥140 mm Hg; and by their HbAlc level： tight control 〈 6. 5%, usual control 6. 5% -7.5%, or uncontrolled, ≥7.5% respectively. Carotid uhrasonography was performed in all subjects for the evaluations of intima-media thickness （IMT） and plaque. Results Multiple linear regression analyses revealed that IMT was positively correlated with SBP （ β = 0. 215, P = 0. 002） and HbAlc （ β = 0. 149, P = 0. 031 ）, whereas IMT was negatively correlated with high-density lipoprotein cholesterol （ β= - 0. 196, P = 0. 002）. According to the multivariate logistic regression analysis, SBP ≥ 140mmHg （OR=1.473, 95%CI1.044-2.078 P=0.027）, HbAlc 〉17. 5% （0R=1.445, 95%CI 1. 031 - 2. 027, P = 0. 033 ） and total cholesterol （ OR = 1. 014, 95% CI 1. 004 - 1. 024, P = 0. 019 ） were significant risk factors for carotid artery atherosclerotic plaques whereas high-density lipoprotein cholesterol （ OR =0. 895, 95% CI 0. 805 -0. 994, P =0. 012） was a protective factor for carotid artery atherosclerotic plaques in elderly patients with hypertension and T2DM. Conclusion There is a significant correlation between the levels of blood pressure, blood glucose and carotid atherosclerosis in elderly patients.