糖尿病下肢动脉病变的影响因素分析

Related factors of lower extremity artery disease in type 2 diabetic inpatients

目的:了解合并下肢动脉病变(LEAD)的糖尿病患者的临床特征,分析其影响因素。方法:根据血管多普勒超声结果,将859例2型糖尿病患者分为合并下肢动脉病变组(LEAD+组)和不合并下肢动脉病变组(LEAD-组),比较两组的临床特点,并分析下肢动脉病变的相关因素。结果:LEAD+组年龄、病程、收缩压(SP)、空腹血糖(FPG)、超敏C反应蛋白(sCRP)、尿素氮(BUN)、Lp(a)水平较LEAD-组明显增高,而肾小球滤过率(GFR)明显降低;两组的舒张压(DP)、BMI、糖化血红蛋白(HbAlc)、脂蛋白E(ApoE)、丙氨酸转氨酶(ALT)、肌酐(Cr)、血清胰岛素(FINS)及胰岛素抵抗指数(IRI)等差异无统计学意义。糖尿病患者下肢动脉病变的发生与年龄、病程、FPG和SP、sCRP、Lp(a)、BUN呈正相关,而与GFR呈负相关。多元逐步回归分析显示,影响糖尿病患者下肢动脉病变的独立相关因素依次为年龄、SP、Lp(a)、FPG、GFR、BUN和病程。结论:年龄、SP、Lp(a)、FPG、肾脏病变和病程是糖尿病下肢动脉病变的主要危险因素。

Objective： To investigate the risk factors of peripheral artery disease（LEAD） through analyzing the clinical characteristics in type 2 diabetic patients. Methods： Based on the ultrasonic artery scan, 859 cases of type 2 diabetic patients were divided into LEAD＋ group（n=418） and LEAD-group（n=441）. The clinical characteristics of two groups were compared, and the factors associated with LEAD were analyzed. Results： Age, duration of diabetes, SP, FPG, sCRP, BUN and Lp （a）levels were higher, but the GFR were lower significantly in LEAD＋ group than those of LEAD-group. However, there was no significant difference of dilated pressure, BMI HbA1c, ALT, Cr and FINS, IRI between two groups. The pearson correlation analysis showed that age, diabetic duration, FPG, SP, sCRP, Lp（a）and BUN were positively correlated with LEAD, but GFR was negatively associated with it. The multiple stepwise regression analysis showed that age, SP, Lp （a）, FPG, GFR, BUN and diabetic duration were independent influencing factors of LEAD in turn. Conclusions： Age, SP, Lp（a）, FPG, diabetic duration and complicated nephropathy are important risk factors of diabetic LEAD.