用踝肱血压比评价2型糖尿病患者周围血管疾病及相关危险因素

Peripheral vascular disease in type 2 diabetic patients evaluated by ankle-brachial index and relative risk factors

目的用踝肱血压比(AB I)评价2型糖尿病患者周围血管疾病(PVD)发病情况及相关危险因素。方法选择113例门诊50岁以上的2型糖尿病患者,收集病史,检测代谢指标,检测双下肢AB I,以AB I<0.9定义为存在PVD。结果在2型糖尿病患者中PVD检出率16.8%。血糖控制差(GHbA1c≥7.5%)的患者中PVD的检出率明显高于血糖控制好至一般的患者(P=0.01)。合并PVD的2型糖尿病患者的年龄、甘油三酯水平、糖尿病病程、冠心病共患病率和吸烟率高于不合并PVD的患者(P<0.05),合并PVD组的患者血清超敏C反应蛋白水平明显高于不合并PVD组(P<0.01)。结论本研究发现在2型糖尿病患者中PVD的患病率为16.8%。与PVD相关的危险因素包括高龄、高甘油三酯、糖尿病病程长、同时患有冠心病和吸烟,以及较高的血清超敏C反应蛋白水平。因此对于存在以上危险因素的2型糖尿病患者应该加强对PVD的筛查。

Objective To evaluate the prevalence of peripheral vascular disease （PVD） in type 2 diabetic patients by ankle-brachial index （ABI） and relative risk factors for PVD. Methods We recruited 113 type 2 diabetic patients from out-patient clinic, collected medical history and fasting blood sample for measurement of metabolic indexes. We screened the patients by ABI, and PVD was defined by ABI 〈0.9. Results The PVD prevalence was 16.8% in 113 type 2 diabetic patients. Patients of poor blood glucose control （GHbA1c≥7.5%） had higher prevalence of PVD than patients who had good to normal glucose control （P = 0.01 ）. Diabetic patients witb PVD had older age, higher triglyceride level, longer diabetic duration, higher prevalence of CHD and smoking （ P 〈 0.05 ）, and much higher serum hsCRP level （P 〈0.01 ） than diabetic patients without PVD. Conclusion We found the prevalence of PVD was 16.8% in type 2 diabetic patients. Risk factors for PVD in diabetic patients including older age, higher serum triglyceride level, longer duration of diabetes, combined with CHD and smoking, and much higher serum hsCRP level. So we should screen diabetic patients with those risk factors.