2型糖尿病患者踝肱指数与下肢动脉彩超检测指标的相关性研究

Association of Ankle-brachial Index and Color Doppler Ultrasonography of Lower Extremity Artery in Patients with Type 2 Diabetes

目的探讨2型糖尿病(T2DM)患者踝肱指数(ABI)与下肢动脉彩超检测指标之间的关系。方法对398名T2DM患者采用多普勒血流探测仪测定ABI,并依据ABI分为周围动脉病变(PAD)组(ABI<0.9)87例和非PAD组(ABI≥0.9)311例,同时所有患者进行下肢动脉彩超检测,并对检测指标进行线性相关分析及多元线性回归。结果 PAD组左右腘动脉内径、左右胫后动脉内径、左右胫后动脉血流峰值流速(PSV)、左右足背动脉内径、左右足背动脉血流PSV均低于非PAD组,差异均有统计学意义(P<0.05)。以左侧肢体为例,Pearson相关分析显示,左ABI与左股动脉内径、左腘动脉内径、左胫后动脉内径、左胫后动脉血流PSV、左足背动脉内径、左足背动脉血流PSV呈正相关(r值分别为0.113、.232、.171、000.237、0.130、0.194,P<0.05,P<0.01)。多元逐步回归显示,左ABI与年龄、左腘动脉内径、左胫后动脉血流PSV、低密度脂蛋白胆固醇(LDL-C)、左足背动脉血流PSV、体质指数(BMI)相关(R2值分别为0.118、.170、.206、0.223、0.238、.250,<000P0.01,P<0.05)。结论 T2DM患者周围动脉越狭窄,彩色超声检测显示其血管内径、PSV越低。

Objective To investigate the relationships between ankle-brachial index（ABI） and color Doppler ultrasound of lower extremity artery in patients with type 2 diabetes mellitus（T2DM）.Methods ABI was examined in the 398 patients with type 2 diabetes by Doppler flow detector.All the patients were divided into group A（ABI≥0.9,n=311） and group B（ABI0.9,n=87）.The lower extremity arteries in all patients with type 2 diabetes mellitus were checked again by color Doppler ultrasound.Their relationships of the results were analyzed.Results（1） The inner diameters of the left and right popliteal artery,the left and right posterior tibial artery and the left and right dorsal artery were smaller in group B than in group A;and the maximum velocity of blood flow of the left and right posterior tibial artery and the left and right dorsal artery were slower in group B than in group A.（2） Taking left limb as the example,left ABI was positively correlated with the inner diameter of the left femoral artery,the left popliteal artery,the left posterior tibial artery and the left dorsal artery,and it was positively correlated with the maximum velocity of blood flow of the left posterior tibial artery and the left dorsal artery in T2DM patients.（3） After adjusted with a series of confounding factors such as course of disease,SBP,TC,and BUN,multivariate analysis demonstrated that left ABI was associated with age,the inner diameter of the left popliteal artery,the maximum velocity of blood flow of the left posterior tibial artery,LDL-C,the maximum velocity of blood flow of the left dorsal artery and BMI.Conclusion In type 2 diabetes,the narrower the artery is,the lower the inner diameter and the maximum velocity of blood flow of lower extremity artery checked by color Doppler ultrasound are.