踝臂指数评价糖尿病合并下肢动脉病患者治疗效果研究

Application of Ankle-brachial Index for Evaluating Therapeutic Effectiveness of Peripheral Arterial Disease in Aged Diabetic Patients

目的探讨踝臂指数(ABI)作为糖尿病合并下肢动脉病(PAD)患者治疗效果评价指标的价值。方法糖尿病合并PAD患者106例,随机分为两组:单纯药物治疗(A组)64例,其中男38例,女26例;平均(74±6)岁;介入治疗+药物治疗(B组)42例,其中男29例,女13例,平均(73±5)岁。分别于治疗前及治疗后1、3、6、12个月检测ABI。结果老年糖尿病合并PAD患者治疗前ABI<0.90。B组治疗后1、3、6、12个月的ABI与治疗前相比,差异均有统计学意义(P<0.05)。B组中11例于治疗后12个月ABI<0.90,经下肢动脉造影证实支架内再狭窄。治疗后1、3、6、12个月两组的ABI比较,差异均有统计学意义(P<0.01)。结论介入治疗能够及早改善老年糖尿病合并PAD患者的血运,比单纯药物治疗疗效显著。ABI在评价治疗效果中起着重要的作用。

Objective To explore the feasibility of using ankle - brachial index （ ABI ） for evaluating the treatment outcomes of peripheral arterial disease （PAD） in the aged patients with type 2 diabetes mellitus （T2DM）. Methods Totally 106 elderly T2DM patients with PAD were randomly divided into two groups： group A receiving simple drug treatment （n = 64;38 males and 26 females; average age： 74 ± 6 years） and group B receiving interventional therapy and drug treatment （n = 42; 29 males and 13 females; average age： 73 ± 5 years）. All the patients were checked for ABI before treatment and 1, 3, 6, and 12 months after treatment. Results ABI was 〈 0. 90 in elderly T2DM patients with PAD before treatment. In group B,ABI significantly changed 1, 3, 6, and 12 months after treatment （P 〈0.05）. Also in group B, ABI was less than 0. 90 after 12 months＇ treatment, and in -stent re- stenosis was confirmed by lower- extremity arteriography in these patients. ABI be- tween group A and group B showed significant differences after 1, 3, 6, and 12 months of treatment （P 〉0. 05）. Conclusion Interventional therapy can improve the blood circulation in elderly T2DM patients with PAD earlier and more effective than sim- ple drug treatment. ABI can be a useful indicator for evaluating the treatment effectiveness of PAD.