代谢综合征患者合并外周动脉疾病的临床研究

Metabolic syndrome complicated by peripheral arterial disease; clinical study of 2115 cases

目的了解代谢综合征患者合并外周动脉疾病(PAD)的发病情况,以及代谢综合征与PAD相关危险因素的关系。方法住院和门诊2115例代谢综合征患者,年龄32-91(67．6±5．1)岁,男1132例,女983例。收集相关的临床资料和进行踝臂指数测定,踝臂指数小于0．9诊断有PAD,并进行PAD相关临床资料的分析和统计学处理。结果代谢综合征合并PAD的患者为476例,总的发病率为22．5％。男性246例,占代谢综合征合并PAD患者的51．68％;女性则为230例(48．32％);平均年龄分别为71．3±9．4和71．2±8．2岁。代谢综合征患者随着年龄的增长患PAD的危险性增高,OR值为1．069,95％可信区间为1．054-1．083,而且与性别、吸烟、糖尿病、冠心病和缺血性卒中有相关性(均P<0．05)。女性代谢综合征合并PAD患者与非PAD患者相比,血尿素氮,血肌酐和血尿酸的水平明显较高(P<0．05)。结论代谢综合征患者易合并PAD,并随着年龄的增长,相关危险因素的增加,代谢综合征患者更易患PAD。女性代谢综合征合并PAD患者与非PAD患者相比肾功能减弱明显。

Objective To investigate the prevalence of peripheral arterial disease （PAD） complicated in metabolic syndrome （ MS ） and its risk factors. Methods The clinical data of 2115 inpatients and out-patients with MS, 1132 males and 983 females, aged 67.6±5.1 （32 ～ 91 ）, diagnosed and treated in several hospitals in Beijing and Shanghai, were collected. The patients underwent measurement of the systolic pressures of the brachial artery and ankle artery so as to calculate the ankle-brachial index （ABI）. An ABI less than 0. 9 was considered to be indicative of significant PAD. The data underwent statistical analysis. Results 476 patients （22. 5% ） were found to have PAD, among which 246 were male aged 71.3±9.4 （51.68% ） and 230 were female （48.32%） aged 71.2±8.2. The risk of PAD among then MS patients became higher along with the increase of age （ OR = 1. 069, 95% CI = 1. 054 ～ 1. 083 ） , gender （ OR = 1. 498, 95 % CI = 1. 091-2. 058）, smoking status （ OR = 1. 763, 95% CI = 1. 294 ～ 2. 402 ） , history of coronary heart disease, history of diabetes mellitus, and history of stroke were independently associated with low ABI （ ABI 〈 0.9 ） （ all P 〈 0. 05 ）. higher blood urea nitrogen, creatine （ CRE ） , and uric acid values of the female MS patients complicated by PAD was 7 mmol/L ±4 mmol/L, 101 mmol/L ± 77 mmol/L, and 343 mmol/L ± 115 mmol/L respectively, all significantly higher than those of the female MS patients not complicated by PAD （6 mmol/L ±4 mmol/L, 84 mmol/L ± 70 mmol/L, and 308 mmol/L ± 100 mmol/L respectively, P 〈 0. 0001, P = 0. 002, and P 〈 0. 001 ）. However, the BUN value of the male patients with MS complicated by PAD was 7.2 mmol/L ± 4. 9 mmol/L, significantly higher than that of the male MS patients nor complicated b PAD （6.5 mmol/L ± 4. 3 mmol/L, P = 0. 036）, however, he values of CRE and UA of the male MS patients complicated and not complicated by PAD were not significantly different （ both P 〉 0. 05 ）, only the value of BUN of the of the male MS patients complicated by PAD was 7. 2±4. 9 at high risk of PAD in female patients, NOT in male patients except BUN value（P 〈 0. 05 ）. Conclusion Patients with MS have high risk of complication by PAD, especially when they become older. Female patients with MS are more likely to have a trend towards kidney dysfunction.