强化血糖、血脂、血压控制对2型糖尿病并下肢动脉病变患者踝臂指数的影响

Effect of Intensive Control of Blood Glucose,Lipid,and Pressure on ABI in Patients with Type-2 Diabetic Peripheral Arterial Disease

目的观察强化血糖、血脂、血压控制对2型糖尿病(T2DM)并下肢动脉病变患者踝臂指数(ABI)的影响。方法将84例2型糖尿病并下肢动脉病变患者随机分为强化组和常规组各42例。根据血压、血脂水平将强化组分为合并血压升高组(n=25)和合并血脂升高组(n=23)。强化组予强化血糖、血脂、血压控制,常规组给予常规治疗,疗程1年,分别测定强化组和常规组治疗前后收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、甘油三酯(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)和ABI,并对合并血压升高组和合并血脂升高组ABI进行比较。结论与治疗前相比,强化组达标患者1年后HbA1c、SBP、DBP、TC、TG、HDL-C、LDL-C、ABI差异均有统计学意义(P<0.05,P<0.01);常规组仅HbA1c差异有统计学意义(P<0.05)。治疗后两组各观察指标比较差异均有统计学意义(P<0.01)。合并血脂升高组和合并血压升高组治疗后ABI均高于治疗前,差异均有统计学意义(P<0.05)。结论强化血糖、血脂、血压控制可提高T2DM并下肢动脉病变患者ABI值,改善下肢动脉病变病情。

Objective To observe the effect of intensive control of blood glucose, lipid, and pressure on ankle braehial index（ABI） in type-2 diabetic peripheral arterial disease patients. Methods 84 patients with type-2 diabetic peripheral arterial disease were randomly divided into intensive group and conventional group （42 each） , and the intensive group was divided into hypertension group （n = 25 ） and hyperlipemia group（ n = 23 ） according to the levels of blood lipid and pressure in the patients before treatment. Intensive group received intensive control of blood glucose, lipid and pressure, the conventional group received conventional therapy,and both groups were treated for a year. SBP, DBP, TC, TG, LDL-C, HDL-C, HbAlc and ABI were observed and compared before and after treatment. Results There was significant difference in HbA1c, SBP, DBP, TC, TG, LDL-C, HDL-C and ABI before and after treatment（P 〈0. 05, P 〈 0. 01 ） , but in conventional group, only HbAlc showed significant difference before and after treatment（ P 〈 0. 05 ）. One year after treatment, there was significant difference in all the indexes between the two groups（P 〈 0. 01 ）, and ABI in both hypertension group and hyperlipemia group was higher than that before （ P 〈 0. 05 ）. Conclusion Intensive control of blood glucose, lipid and pressure can improve the ABI and pathogenetic condition in patients with type-2 diabetic peripheral atrerial disease.