踝肱指数和微量白蛋白尿预测2型糖尿病心脑血管病变的临床研究

Role of ankle-brachial index and microalbuminuria in predicting cardio-cerebrovascular diseases in T2DM patients

目的通过分析T2DM患者踝肱指数(ABI)、微量白蛋白尿(MAU)与糖尿病心脑血管疾病的关系,比较两者在预测T2DM患者心脑血管疾病中的作用。方法回顾性分析531例T2DM患者的一般情况、生化指标、ABI、MAU以及心脑血管并发症的患病情况。结果 T2DM患者伴有心脑血管疾病者204例(38.4%)。ABI和MAU异常组较正常组年龄大、病程长、SBP和2hPG高,合并心脑血管疾病多。进一步按年龄和病程分组比较发现,≤60岁、病程≤15年时,ABI异常患者合并心脑血管并发症的比例不仅高于同年龄、同病程的ABI正常组,而且高于相应的MAU异常组(P<0.05)。结论 ABI和MAU异常同为T2DM患者心脑血管疾病的危险因素,但对于年龄小且病程短的患者,ABI对心脑血管疾病预测作用优于MAU。

Objective To analyze the relationships of ankle-brachial index （ABI） and microalbuminuria （MAU） with cardio-cerebrovascular diseases in T2DM patients for comparing their roles in predicting cardio-cerebrovascular diseases. Methods The general conditions, biochemical indicators, ankle-brachial index （ABI）, MAU, cardiovascular and cerebrovascular complications of the 523 hospitalized T2DM patients were analyzed in this retrospective study. Results Cardiovascular and cerebrovascular diseases were found in 204 patients, the incidence was 38.4%. Patients with abnormal ABI or MAU were elder in age, with longer diabetic duration, higher systolic blood pressure （SBP） and 2-hour postprandial blood glucose （2 hPG）, and more complications of cardio-cerebrovascular disease than those in the normal groups （P〈0.05）. It was further found that the prevalence of cardiovascular and cerebrovascular diseases in ABI abnormal patients who were aged under 60 years with a diabetic duration less than 15 years was significantly higher not only than those patients with normal ABI at the same age with the same diabetic duration, but also than those patients with abnormal MAU （P〈0.05）. Conclusion Both ABI and UAER are the risk factors of cardiovascular and cerebrovascular diseases in T2DM. But for younger patients with shorter diabetic duration, ABI is stronger than MAU in predicting cardio-cerebrovascular diseases.