438例住院2型糖尿病患者踝肱指数及相关指标分析

Ankle Brachial Index and Related Clinical Indicator in 438 Patients with Type 2 Diabetes

目的了解2型糖尿病中异常踝肱指数(ABI)的发生率,并探讨其与临床相关指标的关系,为糖尿病慢性并发症的防治提供理论依据。方法 438例确诊为2型糖尿病的住院患者,分为ABI正常组(0.9≤ABI≤1.3)325例、低ABI组(ABI<0.9)98例及高ABI组(ABI>1.3)15例,所有患者均进行ABI及糖化血红蛋白(HbA1c)等生化资料的检测并收集临床病史资料进行回顾性分析。结果①ABI的异常率为25.8%,低ABI组的年龄、病程、HbA1C、LDL、超敏CRP均高于正常组,高ABI组的年龄、超敏CRP明显高于低ABI组,差异有统计学意义(P<0.05);三组间比较,高血压、吸烟史、糖尿病肾病、糖尿病视网膜病变、周围神经病变、心脑血管病变及糖尿病足差异有统计学意义(P<0.05)。②Logistic回归显示:2型糖尿病患者的年龄、病程、HbA1C及视网膜病变、心脑血管病、糖尿病足是低ABI的独立危险因素;吸烟及高血压是高ABI的危险因素。结论 ABI降低或异常升高可较好的预测糖尿病慢性并发症及心脑血管疾病的发生,对有ABI异常的2型糖尿病患者采取积极有效的干预措施意义重大。

Objective To explore the incidence of abnormal ankle brachial index （ABI） in patients with type 2 diabetes and its relationship with relevant clinical indicator and to provide theoretical basis for preventing chronic complications in type 2 diabetes. Methods 438 cases with type 2 diabetes were divided into three groups ： Normal ABI group （0.9≤ ABI ≤ 1.3, n = 325）, low ABI group （ ABI 〈 0.9, n = 98） and high ABI group （ABI 〉 1.3, n = 15）. ABI, glycosylated hemoglobin （HbA1 c） and other biochemical data were also collected and analysed. Results HbA1C, LDL, high sensitive CRP ① the abnormity rate of ABI was 25.8%. The age, course of disease, in low ABI group was significantly higher than those in normal group. The age, high sensitive CRP in high ABI group was significantly lower than those in low ABI group （ P 〈 0.05 ）. The history of smoking, hypertension, diabetic nephropathy, diabetic retinopathy, peripheral neuropathy, vascular disease and diabetic foot were significantly different among three group （P 〈 0.05 ）. ②the result of logistic regression revealed the age, course of disease, HbA1 C and retinopathy, cardio -cerebral vascular disease, diabetic foot were independent risk factors of low ABI. Smoking and hypertension were risk factors of high ABI. Conclusion The decreased ABI or abnormal elevated levels may be better predictors for chronic complication of diabetes mellitus and cardiovascular diseases. It is of great significance to take active and effective intervention measures for patients with abnormal ABI.