踝臂指数评价糖尿病患者下肢动脉病变的危险因素

The risk factors of diabetic patients with peripheralarterial disease by ankle-brachial index

目的通过踝臂指数(ABI)评价糖尿病患者合并下肢动脉病变(PAD)的危险因素。方法 160例糖尿病患者行ABI检测,同时收集年龄、性别、糖尿病病程及吸烟史等资料,测量收缩压(SBP)、舒张压(DBP)、身高、体重,计算体重指数(BMI),并检查总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)、血及尿β2微球蛋白(β2-MG)、尿素氮(BUN)、肌酐(Cr)、超敏C反应蛋白(hs-CRP),按ABI≤0.9或ABI>0.9分为A、B两组。结果两组相比,年龄、病程、吸烟例数、SBP、TG、LDL-C、HbA1c、血及尿β2-MG、hs-CRP差异有统计学意义(P<0.05或P<0.01)。以ABI为因变量,以年龄、病程、吸烟例数、SBP、TG、LDL-C、HbA1c、血及尿β2-MG、hs-CRP等为自变量进行逐步回归分析显示吸烟(P=0.003)、hs-CRP(P=0.003)、HbA1c(P=0.007)、LDL-C(P=0.008)、病程(P=0.042)、年龄(P=0.031)、血β2-MG(P=0.047)为最相关因素。结论 ABI检查是发现糖尿病患者合并PAD的简便有效手段,年龄、病程、吸烟、LDL-C、HbA1c、血β2-MG、hs-CRP等为糖尿病患者合并PAD最相关危险因素。

Objective To evaluate the risk factors of the diabetic patients with peripheral arterial disease（PAD） by ankle brachial index（ABI）.Methods ABI was measured in 160 diabetic patients with the data of their age,sex,course of diabetes and smoking history.The systolic blood pressure（SBP）,diastolic blood pressure（DBP）,and height and weight were measured.The body mass index（BMI）,total cholesterol（TC）,triglycerides（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,Glycosylated Hemoglobin A1,blood and urine β2 microglobulin,blood urea nitrogen（BUN） and creatinine（Cr）,and high sensitivity creactive protein（hs-CRP） were all detected.All patients were divided into Group A（ABI≤0.9）and Group B（ABI〉0.9）.Results The difference of the two groups in age,course of diabetes,smoking,SBP,TG,LDL-C,HbA1c,serum and urine β2-MG and hs-CRP had statistical significance（P〈0.05 or P〈0.01）.Stepwise regression analysis made by ABI as dependent variables and age,course of diabetes,smoking,SBP,TG,LDL-C,HbA1c,blood and urine β2-MG and hs-CRP as independent variables suggested that smoking（P=0.003）,hs-CRP（P=0.003）,HbA1c（P=0.007）,LDL-C（P=0.008）,course of diabetes（P=0.042）,age（P=0.031） and blood β2 MG（P=0.047）were the most closely-related factors.Conclusion ABI examination was a simple and effective method to detect the diabetic patients with PAD.Smoking,hs-CRP,HbA1c,LDL-C,course of diabetes,age and blood β2-MG are the most closely-related risk factors of the diabetic patients with PAD.