2型糖尿病合并下肢动脉粥样硬化危险因素分析

Risk Factors of Type 2 Diabetes with Complicated Lower Limbs Atherosclerosis

目的探讨2型糖尿病合并下肢动脉粥样硬化的危险因素。方法回顾性分析我院收治的234例2型糖尿病患者,按照彩色超声检查,将108例2型糖尿病合并下肢动脉粥样硬化患者作为病例组,126例未发生下肢动脉粥样硬化的患者作为对照组。比较病例组与对照组患者的糖尿病病程、年龄、收缩压、舒张压、体质指数(BMI)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、空腹胰岛素(FINS)、血脂[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、胰岛素抵抗指数(HOMA-IR)、尿微量清蛋白(UMA)等因素,并对因素做多元线性回归分析。结果病例组与对照组的糖尿病病程、收缩压、FBG、2 hPBG、TG、HDL-C、HbA1c、LDL-C、FINS、UMA比较,差异有统计学意义(P<0.05)。回归分析显示,FBG、LDL-C、HbA1c、UMA是糖尿病下肢动脉粥样硬化的独立危险因素。结论防治2型糖尿病合并下肢动脉粥样硬化应同时进行多因素全面控制,尤其应注意血糖、血压、脂代谢和UMA的控制。

Objective To explore the risk factors for type 2 diabetes with complicated lower extremity arterial athero- sclerosis. Methods Retrospective analysis was carried out in 234 hospitalized patients with type 2 diabetes, who were divided in- to two groups according to color Doppler ultrasound examination： the ease group （ 108 patients with lower extremity arterial ather- osclerosis） and the control group （ 126 patients without lower extremity arterial atherosclerosis） . Factors including duration of di- abetes, age, SBP, DBP, BMI, HbAlc, FBG, 2 hPBG, FINS, TG, TC, LDL-C, HDL-C, HOMA-IRand UMA were compared between the two groups and multivariate linear regression analysis was performed on these factors. Results Diabetes du- ration, SBP, FBG, 2 hPBG, TG, HDL- C, HbA1c, LDL- C, Hb1c, and UMA showed statistically significant differences between the case group and the control group （P 〈 0. 05 ） . Regression analysis showed that FBG, LDL - C, FINS, and UMA were among the independent risk factors of diabetic lower limb atherosclerosis. Conclusion Prevention of type 2 diabetes with complicated lower extremity atherosclerosis calls for comprehensive control of multiple factors, with particular attention to blood sugar, blood pressure, lipid metabolism and UMA paid.