糖尿病合并高血压患者下肢动脉粥样硬化与大血管并发症的相关性研究

Correlation Study between Lower Extremity Atherosclerosis,Ankle Brachial Index and Macrovascular Complications in Diabetic Patients with Hypertension

目的通过下肢血管彩超、踝-肱指数(ankle brachial index,ABI)监测,探讨糖尿病、高血压及糖尿病合并高血压患者下肢动脉粥样硬化病变的特征,并了解下肢动脉粥样硬化与大血管并发症的发病及进展的关系。方法采用彩色多普勒超声技术及多普勒血流探测仪分别监测双下肢动脉血管粥样硬化情况及踝动脉与肱动脉收缩压的比值,通过卡方检验对糖尿病(diabetes mellius,DM)组、高血压(hypertension,HT)组、糖尿病合并高血压(diabetes mellitus-hypertension,DM-HT)组及非糖尿病非高血压(nondiabetes metus-non-hypertenson,N-DM N-HT)组患者的下肢动脉粥样硬化发病及特征进行分析、并统计各组大血管并发症发病情况,分析下肢动脉粥样硬化与大血管并发症的相关性。结果彩色多普勒超声检查示:DM组及HT组下肢动脉粥样硬化的发现率明显高于N-DM-N-HT组(P<0.01),并且DM-HT组最高,发现率为82.06%。ABI检测示:ABI<0.9的发现率在DM-HT组最高,为16.27%,且与N DM-N-HT组比较差异具有显著性(P<0 01)。下肢动脉粥样硬化程度与大血管并发症的发生密切相关(K0.01)。结论糖尿病及高血压患者下肢动脉粥样硬化病变较严重,下肢彩色多普勒超声及ABl监测结果与大血管并发症的发生密切相关。

Objective To observe the characteristics of lower extremity atherosclerosis in diabetic patients and hypertension patients by Lower extremity vascular ultrasound and ankle brachial index（ABI）, and to understand the relationship between the incidence and progression of lower extremity atherosclerosis and macrovascular complications. Methods We chose color Doppler ultrasound and ABI to monitor the incidence and characteristics of lower extremity atherosclerosis in diabetic patients（DM）, hypertension patients（HT）, diabetic patients with hypertension（DM-HT） and patients without diabetes（N-DM） and hypertension（N-HT）. Then we collected the data of macrovasular complications in each group. Results The incidence of lower extremity atherosclerosis in DM group and HT group are significantly higher than that in non-diabetes mellitus-non-hypertension group（P〈0.01）. And the incidence of Lower extremity atherosclerosis in DM group is even higher than that in HT group, particularly in moderate to severe stenosis（82.06%）. The incidence of marcovascular complications is closely related to the severity of lower extremity atherosclerosis. Conclusions The severity of lower extremity atherosclerosis is more severe in diabetic patients and hypertension patients. Color Doppler ultrasound and ABI are the easy and efficient ways to monitor the severity of lower extremity atherosclerosis; both of them are closely related to the incidence of macrovascular complincations.