踝肱指数诊断糖尿病下肢动脉病变的临床意义

The clinical significance of ankle-brachial index in diagnosing lower extremity artery disease in diabetic patients

目的了解踝肱指数(ABI)在诊断2型糖尿病(T2DM)患者下肢动脉病变中的意义及影响因素。方法选择300例T2DM患者,测定足背动脉与肱动脉的比值,有1侧ABI<0.9即纳入低ABI组,2侧ABI均≥0.9者为对照组。比较2组体重指数(BMI)、腰臀比(WHR)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbAlc),以及相关血脂水平。结果 ABI<0.9者78例(低ABI组),ABI>0.9者222例(对照组)。2组年龄、糖尿病病程、TG、LDL-C、舒张压、2hPG差异有统计学意义;2组性别比、BMI、WHR、收缩压、TC、HDL-C无统计学差异。逐步回归分析显示:年龄、病程、LDL-C是影响ABI的独立因素。结论 ABI是诊断糖尿病患者下肢动脉病变的可靠指标。下肢动脉硬化加剧的主要因素为年高龄、病程长、脂代谢紊乱及高血糖。

Objective To study the significance of ankle-brachial index（ABI） in diagnosing the lower extremity artery disease（LEAD） in T2DM patients and to identify the influence factors.Methods 300 cases of T2DM patients were confirmed with ABI.The ABI index of patients in low ABI group was unilaterally less than 0.9,which in control group was bilaterally higher than 0.9.The levels of BMI,WHR,2hPG,HbAlc and related blood lipid were detected.Results ABI0.9 was detected in 78 patients（low ABI group）,while ABI ≥0.9 was in 222 patients（control group）.There were statistically differences in age,diastolic duration,TG,LDL-C,DBP,2hPG between the two groups.There was no statistically difference in sex ratio,BMI,WHR,SBP,TC,HDL-C between the two groups.The correlation analysis indicated that age,diastolic duration and low density lipoprotein cholesterol were independent factors that affected ABI.Conclusion ABI is a reliable index to diagnose the lower extremity artery disease.Age duration,hyperlipemia and hyperglycaemia are main factors to intensify lower extremity arteriosclerosis.