糖尿病大血管和微血管并发症危险因素分析

Analysis of risk factors related to diabetic vascular complications

目的探讨影响糖尿病大血管及微血管并发症的主要危险因素。方法561例2型糖尿病患者按是否合并脑梗死、冠心病、糖尿病肾病、糖尿病视网膜病变(DR)和糖尿病周围神经病变(DNP)分成4组:糖尿病无血管并发症组、糖尿病大血管、微血管并发症组、糖尿病大血管并发症组、糖尿病微血管并发症组。结果(1)糖尿病血管并发症患病率为56.68%,糖尿病(病程<0.5年者大血管并发症的患病率为8.27%,微血管并发症患病率为35.5%。(2)随糖尿病病程延长或增龄,糖尿病大血管、微血管并发症的患病率均明显增加。(3)糖尿病大血管并发症主要与高血压、高胰岛素血症、高龄和病程有关,而微血管并发症主要与高血糖、病程有关,与高胰岛素血症负相关。结论在临床诊断2型糖尿病之前,部分患者已出现糖尿病大血管、微血管并发症,并随病程延长或增龄血管并发症的患病率明显增加。代谢综合征是糖尿病大血管、微血管的共同危险因素。

Objective To investigate risk factors related to diabetic macro and micro vascular complications.Methods 561 inpatients of type 2 DM diagnosed by 1997 ADA criteria were divided into four groups ：DM group, macroangiopathy group, microangiopanthy group and Macro ＋ Micro group. Results 1. The incidence of diabetic vascular complications was 56.68 %. In newly diagnosed diabetics （duration of diabetes 〈 0.5year）, the incidence of diabetic macro vascular complications was 8.27%, microvascular complications 35.5% . 2. The longer duration of diabetes or the elderly of the patients, the higher incidence of diabetic vascular complications. 3. Research manifested that diabetic macro vascular complications was postively correlated to HT,hyperinsulinisrn,age and duration of DM; while microvascular complications was postivly correlated to proteinuria,hyperglycemia and duration of DM, negatively correlated to hyperinsulinemia .Conclusion 1 .Before diagnosis of diabetis mellitus, some cases have diabetic macro and micro vascular complications; 2. The incidence of diabetic vascular complications is rising with duration of DM or age. 3. Metabolism syndrome is a risk factor of macro and micro vascular complications.