2型糖尿病患者踝肱指数、趾肱指数的变化及影响因素

Clinical Analysis of Ankle Brachial Index and Toe Brachial Index in Type 2 Diabetes Mellitus

目的:探讨2型糖尿病(T2DM)患者踝肱指数(ABI)、趾肱指数(TBI)的变化及其影响因素。方法:选择303例T2DM患者,以双下肢胫后动脉及足背动脉任一部位ABI<0.9诊断为外周动脉病变(PAD)组;ABI≥0.9为无PAD组。在无PAD组中,将ABI≥1.3的患者分为下肢动脉明显钙化组,无PAD2组;将0.9≤ABI<1.3的患者分为对照组,无PAD1组。观察ABI、TBI与各指标的相关性,对其进行统计分析。结果:PAD组在年龄、患糖尿病的病程、空腹血糖(FBG)、餐后2 h血糖(2 hBG)、糖化血红蛋白(HbA1c)、24 h尿微量白蛋白(UAER)、低密度脂蛋白胆固醇(LDL-C)、血肌酐(Cr)水平方面均高于无PAD组,有统计学意义(P<0.05);双下肢胫后动脉、足背动脉ABI与PBG2 h、HbA1c、总胆固醇(TC)、甘油三脂(TG)、LDL-C及高密度脂蛋白胆固醇(HDL-C)存在相关性,有统计学意义(P<0.05);ABI≥1.3(无PAD2组)的患者,ABI明显高于0.9≤ABI<1.3(无PAD1组)的患者(P<0.05),而TBI两组之间无明显差异。结论:ABI作为评估下肢血液循环不良或损伤的指标,具有无创、简便、价廉等优点;当发生下肢动脉钙化时,TBI检测是ABI的补充。

Objective：To study the changes of ankle-brachial index（ABI） and toe-brachial index（TBI）in type 2 di abetes mellitus（T2DM）. Methods：303 patients with T2DM were divided into 2 groups according to the results of ABI, then the relations between ABI. TBI and various parameters in two groups were observed and analyzed by statistical methods. Results：Patients with peripheral vascular disease in T2DM had markedly higher age. diabetic history. FBG. 2 hBG.HbAlc.UAER.LDL-C.Cr;Multiple linear regression showed that ABI was correlated with PBG2 h.HbAlc. TC. TG.LDL-C 及 HDL-C ;Between 0.9≤ABI〈3 group and ABI≥ 3 group,there were no differences in TBI. Conclusion：It is non-invasive ,easy and economical to check ABI for diagnosing PAD in diabetic patients ;In those patients with overt calification,TBI is the complement of ABI.