老年糖尿病患者红细胞分布宽度与外周动脉疾病的相关性研究

Correlation between red blood cell distribution width and ankle-brachial index in elderly DM patients

目的探讨老年2型糖尿病患者红细胞分布宽度(RDW)与外周动脉疾病(PAD)之间的相关性。方法选择老年2型糖尿病住院患者246例进行横断面研究,按RDW四分位数将患者分为最低四分位数组(A组)56例,低四分位数组(B组)63例,高四分位数组(C组)65例,最高四分位数组(D组)62例。收集临床一般资料及心血管病危险因素,检测空腹血糖、血脂、糖化血红蛋白、肌酐、白细胞、血红蛋白、平均红细胞体积、高敏C反应蛋白,测量踝臂指数(ABI)并进行分析。结果从A组到D组,ABI值逐渐降低,以中位数(四分位间距)表示,分别为1.05(0.14)、1.03(0.21)、1.02(0.26)、0.96(0.28),差异有统计学意义(P<0.05);PAD患病率逐渐升高,分别为14.3%、23.8%、35.4%、41.9%(P<0.05,P<0.01),估算肾小球滤过率水平逐渐降低(P<0.05);Spearman相关分析显示,RDW与ABI呈负相关(r= -0.1 59,P<0.05);logistic回归分析显示,校正性别、年龄及其他传统危险因素后,D组增加PAD风险(OR=3.906,95%CI:1.009～9.232,P<0.05)。结论老年2型糖尿病患者RDW与PAD相关,RDW增高患者发生PAD的风险增加。

Objective To study the correlation between red blood cell distribution width（RDW） and ankle-brachial index（ABI） in elderly DM patients. Methods Two hundred and forty-six eld erly DM patients,enrolled in this cross-sectional study,were randomly divided into group A（n= 56） ,grpup B（n=63） ,group C（n=65） and group D（n=62） according to their RDW. General clin- ical data and risk factors for cardiovascular disease（CVD） were collected. Serum levels of fasting glucose,lipid, glycosalated hemoglobin, creatinine, WBC, hemoglobin, mean corpuscular volume, high sensitivity C reactive protein（hs-CRP）,and ABI were measured and analyzed. Results The ABI decreased to 1.05（0.14）,1.03（0.21） ,1.02（0.26） ,and 0. 96（0. 28）respectively while the indicence of PAD increased gradually to 14.3%,23.8%,35.4% and 41.9% respectively in groups A-D（P〈0.05,P〈0. 01）. The eGFR also decreased gradually（P〈0.05）. Spearman correlation analysis showed that the RDW was negatively correlated with the ABI（r=-0. 159,P〈0.05）. Logistic regression analysis revealed that the risk of peripheral arterial disease（PAD） increased in group D after adjustment of gender, age, and other traditional risk factors（OR=3. 906,95%CI. 1. 009--9. 232,P〈0.05）. Conclusion RDW is correlated with PAD and the risk of PAD increa- ses with the increasing RDW in elderly type 2 DM patients.