2型糖尿病趾肱指数临床分析

Toe-brachial index in the diagnosis of peripheral artery disease and its risk factors in the patients with type 2 diabetes

目的研究趾肱指数（TBI）在诊断2型糖尿病患者下肢动脉病变中临床意义与影响因素。方法采用多普勒血流探测仪检测2型糖尿病患者足趾动脉与肱动脉血压的比值，以TBI≤0．7为切割点分成低TBI组与正常TBI组，并分析比较两组临床及代谢参数。结果238例2型糖尿病患者中TBI≤0．7的32例，占总例数13．4％。低TBI组与正常TBI组比较，其年龄更高，舒张压更低，高血压、冠心病、脑血管病合并率增高；逐步回归分析显示，年龄、舒张压是TBI独立影响因素。结论TBI在诊断2型糖尿病下肢动脉病变中具有重要意义；低TBI患者有更高的心脑血管患病率；高龄、舒张压低是TBI的主要危险因素。

Objective To investigate toe-brachial index （TBI） in the diagnosis of peripheral artery disease （PAD） and its risk factors in the patients with type 2 diabetes. Methods TBI was examined in the 238 patients with type 2 diabetes. The patients were divided into the group with low TBI （TBI ≤0.7） and the group with normal ABI （TBI 〉 0. 7）. The two groups were compared for clinical parameters. Results Thirty two patients （13.4%）with abnormal ABI （TBI≤0.7） showed older age [ （63. 8 ± 9. 9） yrs vs （54.9 ± 10. 8） yrs, P =0. 000] , lower diastolic blood pressure [ （70.5 ±6. 9） mmHg vs （74. 9 ±9. 1） mmHg, P =0. 003] , more frequency of hypertension （56. 3% vs 38. 3%, P =0. 043）, coronary artery heart disease （28. 7% vs 10. 7%, P =0. 020） and cere- bral vascular disease （ 15.6% vs 4. 4%, P = 0. 025 ）. Step-wise analysis screened that age and diastolic blood pressure were the inde- pendent risk factors for TBI. Conclusions Aging and hypertension were the risk factors in the patients with abnormal TBI in type2 di- abetes. TBI was an easy and economical method for diagnosing PAD in patients with type 2 diabetes.