初发2型糖尿病老年患者下肢血管病变的危险因素观察

Related factors of peripheral arterial disease in lower limbs of newly - diagnosed elderly patients with type 2 diabetes

目的探讨初发2型糖尿病老年患者下肢血管病变的危险因素，以避免严重并发症的发生。方法将60例初发2型糖尿病老年患者，根据下肢动脉血管超声结果分为正常组、轻度病变组、中度病变组三组，观察各组间体质量指数（BMI）、血压、总胆固醇、甘油三酯、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（HbAlc）等的变化。结果初发的2型糖尿病老年患者中合并下肢血管病变的患病率为18．3％。初发2型糖尿病老年患者合并轻度下肢血管病变者，其体质量指数、收缩压、总胆固醇、低密度脂蛋白及糖化血红蛋白等指标较正常组明显升高，差异有统计学意义（P〈0．05）；合并中度下肢血管病变者体质量指数、收缩压、舒张压、总胆固醇、低密度脂蛋白及糖化血红蛋白等指标较正常组明显升高，差异有统计学意义（P〈0．05）。与伴有轻度下肢血管病变者相比，患有中度下肢血管病变者舒张压、总胆回醇和糖化血红蛋白明显升高。差异有统计学意义（P〈0．05）。结论初发的2型糖尿病老年患者具有体质量指数、血压、总胆固醇、低密度脂蛋白、糖化血红蛋白等升高明显的特点。应及早采用彩色多普勒超声筛查下肢动脉病变，以早期发现糖尿病周围血管病变，早期干预治疗，从而减少糖尿病足的发病率和致残率，节省医疗费用。

Objective To investigate the characteristics of newly - diagnosed elderly patients with type 2 diabetic who need examinations of lower extremity vessels by color doppler early. Methods Sixty patients were included in our study. According to the results of color doppler of lower extremity vessels, the patients were divided into three groups：normal group, mild group and midrange group. The changes of body mass index （BMI）, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesferol （ HDL - C ）, low density lipoprotein cholesferol （ LDL - C ）, glycosylated hemoglobin （HbAlc） were compared among the three groups. Resultst In the newly- diagnosed elderly patients with type 2 diabetic, the prevalence of lower extremity vessels disease was about 18.3 %. Compared with the normal group, the levels of BMI, systolic pressure, total cholesterol, LDL - C and HbA1 c of the mild group were higher obviously, and there was significance between the two groups （P 〈 0. 05 ）. Compared with the normal group, the levels of BMI, systolic pressure, diastolic pressure, total cholesterol, LDL - C and HbAlc of the midrange group were higher obviously, and there was significance between the two groups （P 〈 0. 05 ）. Comparing with the mild group, the levels of diastolic pressure, total cholesterol and HbA1c of the midrange group were higher obviously, and there was significance between the two groups （P 〈 0. 05）. Conclusions If the newly - diagnosed elderly patients with type 2 diabetic have the characteristics of higher levels of BMI, blood pressure, total cholesterol, LDL - C, HbA1 c, their lower extremity vessels should be examined by color doppler to discover the early diabetic peripheral arterial disease. So it can be treated early and the prevalence and the mutilation rate of diabetic foot of diabetic patient can be decreased. Medical care costs can also be spared.