2型糖尿病下肢血管病变相关因素分析

Analysis on related factors of vascular disease in the lower limbs in type 2 diabetes

目的分析2型糖尿病患者下肢血管病变发生情况及相关危险因素。方法对住院的190例2型糖尿病患者进行详细病史调查及体格检查,生化检查,胰岛素,C肽及相关免疫学检查和双下肢血管彩色多普勒超声检查。结果190例患者中无血管病变者79例(41.6%),有单种血管病变者52例(27.4%),2种血管病变者35例(18.4%),3种以上者24例(12.6%)。2型糖尿病下肢血管病变与年龄、糖尿病病程、高血压病程、糖尿病周围神经病变病程、糖尿病足病史、尿白蛋白、空腹和餐后2h血糖呈正相关,与血浆空腹胰岛素和C肽、HDL呈负相关(P<0.05或=0.01)。结论2型糖尿病患者下肢血管病变是常见并发症,与年龄、糖尿病病程、高血压、血脂、血糖等多种因素相关,与微血管病变有关。其中年龄、高血压、空腹血糖和微量白蛋白尿是糖尿病下肢血管病变的危险因素。超声血管检查能提供无创早期诊断,在临床中方便可行。

Objective To investigate the incidence of vascular disease in the lower extremities and its related risk factors in type 2 diabetic patients. Methods One hundred and ninety type 2 diabetic patients treated in hospital were recruited for the study. The ease history,physical examination, the level of insulin and C-peptide,immunologic test, biochemical tests and ultrasonic Doppler examination were conducted in these patients. Results Ultrasonic examination showed that 79 eases （41.6%）had no vascular lesions in the lower limbs ,52 eases（ 27. 4% ） had one vascular lesion,35 eases （18.4%） had two lesions, and 24 casea （12.6%） had three or more lesions. The lower limb vasculopathy was positively correlated with age, course of diabetes and hypertensive disease, course of neuropathy, diabetic padopathy, mieroalbuminuria, fasting and post blood glucose;and negatively correlated with the level of insulin, e-peptide and HDL levels（ P 〈 0. 05 or =0. 01 ）. Conclusions Vascular lesions in lower limbs were common in type 2 diabetes mellitus,which is correlated with age, course of diabetes, HBP, blood fat and serum glucose. The risk factors were age, hypertensive disease,fasting blood glucose and mieroalbuminuria. These lesions could be found earlier with the ultrasonic Doppler examination.