糖尿病下肢血管病变危险因素分析

Analysis of risk factors for pathological changes of lower limb blood vessels in type 2 DM patients

目的评价糖尿病患者下肢血管病变的发生和影响因素。方法回顾性地分析2002至2004年在我院住院的2型糖尿病(T2DM)患者112例(年龄≥40岁,病程≥5年),全部进行双下肢彩色多普勒检查;部分病例做下肢血管造影检查。比较下肢血管正常组及不同病变组一般情况及生化指标间的差异,并对糖尿病下肢血管病变危险因素采用Logistic回归方法进行分析。结果(1)T2DM患者中有82%伴发下肢血管病变,病变的发生与收缩压、HDL-C、D-二聚体及脂蛋白α水平相关。(2)无血管病变组与不同程度血管病变组的血糖、血脂控制及凝血差异均有统计学意义(P<0.05)。结论糖尿病患者很好地控制血糖、血脂、血压及降低血液黏稠度,有益于预防糖尿病下肢血管病变。

Objective To appraise the development and risk factors for pathological changes in lower limb blood vessels in type 2 DM patients. Methods To analyze retrospectively 112 cases with type 2 DM patients （age≥40 years, course≥5 years） who were hospitalized in Haidian Hospital between 2002 and 2004. All these patients were checked on both lower limbs by Doppler; some of them took the blood vessel imaging on lower limbs. The differences in ordinary and biochemical indices between the control group and various groups of patients were compared, and analyzed by the method of logistic regression. Results （1） The occurrence rate of lower limb blood vessel pathological changes among type 2 DM patients was 82%, and the occurrence of narrowed blood vessels was closely correlated with levels of the fasting blood sugar, high-density lipoprotein （HDL）, D-D dimmer and lipoprotein A. （2） There were remarkable differences in blood sugar, blood lipoprotein and blood co- agulating system （all P〈0. 05） between DM groups with and without peripheral vascular disease. Conclusions Controlling the levels of blood sugar, lipid and blood viscosity is vital for preventing the development of lower limb blood vessel pathological changes in DM patients.