2型糖尿病患者踝臂指数与冠脉病变的相关研究

THE CORRELATION STUDY OF ANKLE BRACHIAL INDEX AND THE SEVERITY OF CORONARY ARTERY LESION IN TYPE 2 DIABETES MELLITUS PATIENTS

目的研究2型糖尿病患者踝臂指数与冠脉病变的关系。方法选择本院确诊2型糖尿病患者152例,依冠脉造影结果按有无冠心病分为观察组(合并冠心病者,104例)与对照组(无冠心病者,48例)。另将观察组依冠脉病变程度分为单支病变组、双支病变组、严重病变组。测定各组患者血糖、血脂、肝肾功能及踝臂指数(ABI)的情况,并进行分析。结果观察组与对照组血糖、血脂及一般情况资料比较差异无明显统计学意义(p>0.05)。观察组ABI值(0.83±0.12)显著低于与对照组(1.03±0.19)(p<0.01)。其中,冠脉严重病变组ABI显著低于单支病变及双支病变组(p<0.01),而后两组ABI比较,差异无统计学意义(p>0.05)。结论 ABI测定对2型糖尿病患者冠脉病变及其严重程度有一定的相关性和预测价值,为临床工作中对2型糖尿病患者动脉粥样硬化性疾病的早期发现提供一个无创、价廉、简单、可重复的有效手段,值得进一步推广。

Objective To investigate the relativity of ankle brachial index and the severity of coronary artery lesion in type 2 diabetes patients. Methods One hundred and twenty - three patients with type 2 diabetes mellitus were selected and divided into two groups according to whether with coronary heart disease（CHD） or not, the observation group（ with CHD, n = 104）, the control group（without CHD, n =48）. Besides, the observation group were also divided into 3 subgroup ac-cording to their severity of coronary artery lesion by coronary angiogram, group a for single coronary artery involved, group b for dual, and group c for three major coronary artery or serious lesion. The data including blood lipid levels, blood glucose levels and ABI was recorded and analyzed. Results There were no statistical differences in the average FBG, 2hPG, TC, TG, LDL - C, HDL - C, BUN and Cr between two groups（p 〉 0. 05 ）. The average ABI of observation group（0. 83 ＋ 0. 12） was much lower than the control group （1.03 ＋ 0. 19）（ t = 15. 510 ,p 〈 0. 01 ）. In the observation group, the average ABI of group c was much lower than the group a and b（ t = - 5. 761, - 6. 990 ,p 〈 0.01 ）. However, there were no statistical differ-ences of the average ABI between group a and b （ t = - 0. 658, p 〉 0. 05 ）. Conclusion The ABI value may predict the extent of coronary artery lesion in type 2 diabetes mellitus patients, which can be a useful noninvasive repeatable tool for evaluating the early stage of arteriosclerosis disease and should be Donularized.