糖尿病肾病并发下肢动脉病变的相关因素分析

A analysis of correlation factors for peripheral arterial disease in diabetic nephropathy patients.

目的探讨糖尿病肾病(DN)和糖尿病并发下肢动脉病变(PAD)的相关影响因素。方法选取DN患者235例(DN组),单纯糖尿病患者102例(DM组),测定两组踝肱指数(ABI)及其他相关指标,研究下肢动脉病变发生情况及其影响因素。结果 DN组下肢动脉病变发生率(63.0%)高于DM组(11.8%),差别有统计学意义;DN PAD+组、DN PAD—组、DM PAD+组、DM PAD—组的年龄、SBP、DBP、LDL-C、FPG、肾小球滤过率(GFR)、纤维蛋白原(FBG)、UA1b/Cr、24h尿蛋白定量差别均具有统计学意义;DN组发生下肢动脉病变的可能影响因素是SBP、UA1b/Cr、GFR、24h尿蛋白定量;DM组发生下肢动脉病变的可能影响因素是SBP、DBP、24h尿蛋白定量。结论收缩压、纤维蛋白原和尿蛋白可能是DN患者并发下肢动脉病变的预警因子,应对其进行筛查,并给予积极的治疗,从而减少或延缓下肢血管病变的发生及发展。

Objective To investigate the influential factors for peripheral arterial disease （PAD） in diabetic nephropathy patients. Methods A total of 337 type 2 diabetic patients with 235 patients having nephropathy （DN group） and 102 patients without nephropathy （DM group） were selected,and the ankle brachial index（ABI） and other indexes were measured. Results The incidence rate of PAD was higher （P〈0. 05）in diabetic nephropathy group （63.0%） than in diabetes group（11. 8%）. The difference in systolic blood pressure （SBP）, diastolic blood pressure （DBP）, low-density lipoprotein （LDL）, fasting serum glucose, glomerular filtration rate （GFR）, fihrinogen （ FBG）, urinary albumin/creatinine （ UAlb/ Cr）, 24-hour urinary protein excretion and age showed statistical significance among groups of DN PAD＋ ,DN PAD-,DM PAD＋, DM PAD-. The possible influential factors for diabetic nephropathy group were SBP, UAlb/Cr, GFR, 24-hour urinary protein excretion. The possible influential factors for diabetes mellitus group were SBP, DBP, 24-hour urinary protein excretion. Condusions The SBP, fibrinogen and urinary protein may be the predicting factors for lower extremity arterial disease.