2型糖尿病患者踝肱指数临床分析

Ankle-brachial index in the diagnosis of peripheral artery disease and its risk factors in the the patients with type 2 diabetes

目的研究踝肱动脉血压指数(ABI)在诊断2型糖尿病患者下肢动脉病变中临床意义与影响因素。方法采用多普勒血流探测仪检测2型糖尿病患者足背动脉、胫后动脉与肱动脉血压的比值,以ABI<0.9为切割点分成低ABI组与对照组,并分析比较两组代谢参数。结果421例2型糖尿病患者中ABI<0.9的63例,占总例数15%,低ABI组与对照组比较,其年龄、糖尿病病程、高血压病程、TC、LDL-C、uAlb、吸烟率明显增高,血管彩超显示病变率较高(P<0.05),逐步回归分析显示,年龄、糖尿病病程、高血压病程、LDL-C为ABI独立影响因素。结论ABI在诊断2型糖尿病下肢动脉病变中具有重要意义;年龄、病程、高LDL-C、高血糖、高血压为下肢动脉病变的主要危险因素。

Objective To investigate Ankle-brachial index（ABI） in the diagnosis of peripheral artery disease （PAD） and its risk factors in the the patients with type 2 diabetes. Methods ABI was examined in the 421 patients with type 2 diabetes. The patients were divided into the group with low ABI （ ABI 〈 0.9） and the group with normal ABI 〉10.9. The two groups were compared for clinical parameters. Statistical analyse were conducted to check the significance and interrelationship. Results 63 patients with abnormal ABI （ ABI 〈 0.9） showed older age （ 63.3 ± 9.9 vs 56.5±12.0 yrs）, longer duration of diabetes（ 8.0 ± 4.0 vs 4.5 ± 3.2 yrs）, longer duration of hypertension（5.6 ± 2.3 vs 3.2 ± 1.2 yrs）, higher levels of serum total cholesterol（5.0 ± 1.3 vs 4.5 ± 1.5 mmol/L） and LDL-C （ 4.3 ± 1.0 vs 2.8 ± 0.8 mmol/L） and HbA1c（ 8.2 ± 2.3 vs 6.7 ± 1.2 % ） ,more frequency of smoking（40% vs 13% ）. Step-wise analysis screened that age, duration of diabetes ,duration of hypertension and LDL-C were the independent risk factors for PAD. Conclusions There are aging, hyperglycemia, hypertension, LDL-C risk factors in the patients with abnormal ABI in type 2 diabetes. ABI is an easy and economical method for diagnosing PAD in patients with type 2 diabetes.