初诊2型糖尿病患者臂踝脉搏波传导速度的影响因素分析

Correlated risk factors analysis of brachial-ankle pulse wave velocity in patients with newly diagnosed type 2 diabetes mellitus

目的探讨臂踝脉搏波传导速度(ba PWV)测定在初诊2型糖尿病(T2DM)患者中的应用及其相关危险因素。方法 134例初诊T2DM患者,均测定ba PWV、颈动脉彩超、神经传导速度(NCV)及相关生化指标,根据ba PWV测定有无异常分为ba PWV正常组(n=53)和ba PWV异常组(n=81)。对两组间的相关检查指标进行单因素分析,通过多因素Logistic回归分析筛查初诊T2DM患者ba PWV的相关危险因素,并对ba PWV和颈动脉彩超这两种关于血管病变的检查方法进行对比分析。结果 ba PWV异常组中收缩压(SBP)、尿酸(UA)、总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FPG)、胱抑素C(Cys C)均高于ba PWV正常组(P<0.05),合并颈动脉病变及糖尿病周围神经病变的比例明显增高(P<0.05)。多因素Logistic回归分析显示:TC、FPG、Cys C为初诊T2DM患者ba PWV异常的相关危险因素(P<0.05)。ba PWV测定的阳性率明显高于颈动脉彩超检查(P<0.001),两种检测方法的吻合度有统计学意义(P<0.05)。结论在初诊T2DM患者中开展ba PWV的检查对早期发现糖尿病血管病变(大血管和微血管)有现实的临床意义,FPG、TC、Cys C是初诊T2DM患者ba PWV异常的相关危险因素。

Objective To discuss the applications and correlated risk factors ofbrachial-anlde pulse wave ve- locity （baPWV） in patients with newly liagnosed type 2 diabetes mellims （T2DM）. Methods BaPWV, carotid color ultrasonography, nerve conduction velocity （NCV） and biochemical indicators were detected in 134 patients of newly diagnosed T2DM. According to baPWV, the 134 patients were divided into two groups： normal baPWV group （n=53） and abnormal baPWV group （n=81）. All data were compared by single factor analysis. The correlated risk factors were detected by logistic regression analysis. BaPWV and carotid color ultrasonography, the two methods for estimating vasculopathy, were compared by Chi-square test. Results Systolic blood pressure （SBP）, uric acid （UA）, total choles- terol （TC）, triglyceride （TG）, fasting plasma glucose （FPG） and cystatin C （CysC） were significantly higher in abnor- mal baPWV group than normal baPWV group （P〈0.05）. The incidence of complicating carotid artery disease and dia- betic peripheral neuropathy were significantly higher in abnormal baPWV group （P〈0.05）. Logistic regression analy- sis showed that TC, FPG and CysC were the risk factors of the patients of newly diagnosed T2DM with abnormal baP- WV （P〈0.05）. The positive rate of baPWV was significantly higher than that of carotid color ultrasonography （P〈 0.001）, and the accordance rate was significantly different between baPWV and carotid color ultrasonography （P〈 0.05）. Conclusion Examination of baPWV in patients of newly diagnosed T2DM has great clinical significance, which is important for discovering macroangiopathy and microangiopathy in early stage of diabetes mellitus. TC, FPG and Cys C are the risk factors of patients of newly diagnosed T2DM with abnormal baPWV.