糖尿病下肢动脉硬化与同型半胱氨酸关系及危险因素分析

目的探讨2型糖尿病患者下肢动脉硬化与同型半胱氨酸(Hcy)的关系及下肢动脉硬化危险因素的分析。方法比较215例2型糖尿病患者和60例健康对照组的血糖、血脂、BUN、Cr、Hcy等多项指标,并对2型糖尿病患者进行下肢动脉彩色多普勒检查,分析上述指标与下肢动脉硬化的关系。结果 (1)糖尿病患者Hcy水平明显高于对照组,且糖尿病组中吸烟、合并高血压、脑梗死、冠心病及下肢动脉硬化者Hcy水平更高。(2)下肢动脉硬化与年龄、病程、收缩压、糖化血红蛋白、肌酐、尿微量白蛋白、尿总蛋白及同型半胱氨酸、高血压病史、脑梗死、冠心病史等相关。(3)下肢动脉硬化与Hcy水平直线相关,回归方程为:(y下肢动脉硬化)=1.245+0.038X(同型半胱氨酸)。结论高Hcy血症与2型糖尿病患者下肢动脉硬化密切相关,预防下肢血管病变需干预多种危险因素。

Objective To observe the relationship between lower limbs atherosclerosis and homocysteine（ Hcy ） as well as the risk factors of arteriosclerosis in type 2 diabetes. Methods Glucose, lipids, BUN, Cr, Hcy and many other indicators were compared in 215 patients with type 2 diabetes mellitus and 60 healthy controls; The group of diabetes mellitus were accepted the arterial color Dopplar ultrasound examination of lowerlimbs, and we analyzed the relationship between the indexes and the atherosclerosis of lower limbs. Results （l）The Hey level of the diabetes mellitus sufferers was significantly higher than that in control group and the Hey was higher in diabetic group with smoking, a history of hypertension, cerebral infarction, coronary heart disease and lower extremity arteriosclerosis. （2）Lower extremity arteriosclerosis was correlated with age, course of disease, systolic blood pressure, HBAIC, creatinine, urinary albumin, urinary total protein and homocysteine, a history of hypertension, cerebral infarction, coronary heart disease history. （3）There were linear correlations between lower extremity arteriosclerosis and the level of Hey, and the regression equation is： Y （ arteriosclerosis ） =1.245＋0.038X （tHey）. Conclusion High Hey levels and lower extremity arteriosclerosis is closely related in type 2 diabetic patients, the prevention of vascular lesions in the lower extremities need the intervention of multiple risk factors.