踝肱指数在老年2型糖尿病外周动脉疾病中的临床应用价值

The clinical value of ankle-brachial index in peripheral artery disease of elderly type 2 diabetic patients

目的:评价踝肱指数(ABI)在老年2型糖尿病(T2DM)伴外周动脉疾病(PAD)中的临床应用价值。方法:454例老年T2DM患者按ABI分为PAD组(ABI<0.9)81例,非PAD组(0.9≤ABI≤1.3)373例,比较2组的临床特征,并分析ABI的相关影响因素。结果:与非PAD组相比,PAD组年龄、尿酸(UA)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、尿微量白蛋白(U-Alb)均升高,而高密度脂蛋白胆固醇(HDL-C)、ABI均降低(P<0.05～P<0.01)。老年T2DM患者的ABI与年龄、病程、UA、TC、LDL-C、U-Alb均呈负相关关系(P<0.05～P<0.01),与HDL-C呈正相关关系(P<0.05);多元线性逐步回归分析显示,年龄、TC、LDL-C、U-Alb是ABI的影响因素。结论:ABI是筛查老年T2DM伴PAD简单、易行、无创且可靠的指标,年龄、TC、LDL-C、U-Alb是ABI降低的主要危险因素。

Objective：To investigate the value of ankle-brachial index（ABI） in peripheral artery disease（PAD） of elderly type 2 diabetic patients. Methods：According to ABI（the cut point is 0.9）,454 elderly type patients with 2 diabetes mellitus（T2DM） were divided into PAD（ABI0.9） group and non-PAD（0.9≤ABI≤1.3） group.The clinical data of the two groups were compared,and the factors related to ABI were analyzed. Results：Compared with non-PAD group,older age,higher levels of uric acid（UA）,total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）,and urine albumin（U-Alb） were shown in patients of PAD group,while high density lipoprotein cholesterol（HDL-C） and ABI were significantly lower（P0.05 to P0.01）.ABI of T2DM in old patients was negatively correlated to age,disease course,UA,TC,LDL-C,and U-Alb（P0.05 to P0.01）,but positively correlated to HDL-C（P0.05）.By multiple linear stepwise regression analysis,it was shown age,TC,LDL-C and U-Alb were major influencing factors of ABI. Conclusions：It is easy and reliable to check ABI for diagnosing PAD in elderly type 2 diabetic patients.Age,TC,LDL-C and U-Alb are major risk factors of low ABI.