不同程度下肢动脉硬化的2型糖尿病患者血压、血脂及内皮素水平比较

Comparison of Blood Pressure,Blood Lipids and Endothelial Level in batients with Type 2 Diabetes Mellitus with Different Degrees of Lower Limb Arteriosclerosis

目的比较不同程度下肢动脉硬化2型糖尿病患者血压、血脂及内皮素水平。方法选择2012年4月至2014年10月解放军第一八〇医院收治的90例2型糖尿病患者为研究对象,根据患者踝肱指数(ABI)的测定结果分为无下肢动脉硬化组22例(0.9≤ABI<1.4),轻度下肢动脉硬化组42例(0.7≤ABI<0.9),中度下肢动脉硬化组18例(0.5≤ABI<0.7),重度下肢动脉硬化组8例(ABI<0.5)。并观察各组患者的血脂、血压及血内皮素1的水平。结果各组患者血总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、收缩压、舒张压和内皮素1比较差异有统计学意义(P<0.05),轻、中、重度下肢动脉硬化组TC[(4.9±1.5)mmol/L、(5.3±2.0)mmol/L、(5.8±2.6)mmol/L]、TG[(1.9±1.1)mmol/L、(2.2±1.3)mmol/L、(2.5±1.5)mmol/L]、LDL-C[(2.88±0.22)mmol/L、(2.96±0.21)mmol/L、(3.65±0.14)mmol/L]、收缩压[(159±53)mm Hg(1 mm Hg=0.133 k Pa)、(168±59)mm Hg、(179±65)mm Hg]、舒张压[(89±22)mm Hg、(95±28)mm Hg、(102±32)mm Hg]和内皮素1[(95±24)ng/L、(99±27)ng/L、(109±29)ng/L]高于无下肢动脉硬化组[(3.9±1.0)mmol/L、(1.2±0.9)mmol/L、(2.71±0.15)mmol/L、(125±44)mm Hg、(73±17)mm Hg、(82±18)ng/L],中、重度下肢动脉硬化组高于轻度下肢动脉硬化组,重度下肢动脉硬化组高于中度下肢动脉硬化组,差异均有统计学意义(P<0.05);轻、中、重度下肢动脉硬化组HDL-C[(1.21±0.09)mmol/L、(1.09±0.06)mmol/L、(0.93±0.02)mmol/L]低于无下肢动脉硬化组[(1.39±0.12)mmol/L],中、重度下肢动脉硬化组低于轻度下肢动脉硬化组,重度下肢动脉硬化组低于中度下肢动脉硬化组,差异均有统计学意义(P<0.05)。结论 2型糖尿病患者动脉硬化程度越严重,血压、血脂及内皮素1水平越高,临床的预防与治疗应着重注意其相关指标,从而使患者获得尽早的治疗。

Objective To compare blood pressure,blood lipids and endothelial level in batients with type 2 diabetes mellitus with different degrees of lower limb arteriosclerosis. Methods Total of 90 type 2diabetes patients admitted to PLA 180 th Hospital from Apr. 2012 to Oct. 2014 were included in the study,and divided into no lower limb arteriosclerosis group[22 cases,0. 9 ≤ankle-brachial index（ ABI）〈 1. 4 ],mild lower limb arteriosclerosis group（ 42 cases,0. 7 ≤ ABI〈 0. 9）,moderate lower limb arteriosclerosis group（ 18 cases,0. 5≤ABI 0. 7）,severe lower limb arteriosclerosis group（ 8 cases,ABI〈 0. 5） according to the patients ABI measurement. And blood lipids,blood pressure and blood endothelin-1 levels of different groups were observed. Results The serum total cholesterol（ TC）,triglyceride（ TG）,high density lipoprotein cholesterol（ HDL-C）,low-density lipoprotein cholesterol（ LDL-C）,systolic blood pressure,diastolic blood pressure and endothelin-1 of different groups were statistically significant（ P〈 0. 05）,mild,moderate,and severe lower limb arteriosclerosis group＇ s TC [（ 4. 9 ± 1. 5） mmol / L,（ 5. 3 ± 2. 0） mmol / L,（ 5. 8 ±2. 6） mmol / L],TG[（ 1. 9 ± 1. 1） mmol / L,（ 2. 2 ± 1. 3） mmol / L,（ 2. 5 ± 1. 5） mmol / L],LDL-C[（ 2. 88 ±0. 22） mmol / L,（ 2. 96 ± 0. 21） mmol / L,（ 3. 65 ± 0. 14） mmol / L ],systolic blood pressure [（ 159 ±53） mm Hg,（ 168 ± 59） mm Hg,（ 179 ± 65） mm Hg],diastolic blood pressure [（ 89 ± 22） mm Hg,（ 95 ±28） mm Hg,（ 102 ± 32） mm Hg] and endothelin-1[（ 95 ± 24） ng / L,（ 99 ± 27） ng / L,（ 109 ± 29） ng / L]were higher than the no lower limb arteriosclerosis group [（ 3. 9 ± 1. 0） mmol / L,（ 1. 2 ± 0. 9） mmol / L,（ 2. 71 ± 0. 15） mmol/L,（ 125 ± 44） mm Hg,（ 73 ± 17） mm Hg,（ 82 ± 18） ng/L],and the moderate and severe lower limb arteriosclerosis groups higher than the mild lower limb arteriosclerosis group,severe lower limb arteriosclerosis group higher than moderate lower limb arteriosclerosis group,the differences were statistically significant（ P〈 0. 05）; mild,moderate and severe lower limb arteriosclerosis group＇s HDL-C[（ 1. 21 ±0. 09） mmol / L,（ 1. 09 ± 0. 06） mmol / L,（ 0. 93 ± 0. 02） mmol / L]were lower than the no lower limb arteriosclerosis group[（ 1. 39 ± 0. 12） mmol / L],moderate and severe lower limb arteriosclerosis group lower than the mild lower limb arteriosclerosis group,the severe lower limb arteriosclerosis group lower than the moderate lower limb arteriosclerosis group,the differences were statistically significant（ P〈 0. 05）. Conclusion The more serious of lower limb arteriosclerosis degree and the higher of blood pressure,blood lipids and endothelial level in patients with type 2 diabetes,therefore the clinical prevention and treatment should be focused on the related indexes,so that patients may receive the treatment as early as possible.