2型糖尿病患者腓肠肌痉挛与踝肱指数关系研究

Study on the association between ankle-brachial index and gastrocnemius muscle spasm in patients with type 2 diabetes mellitus

目的·探讨2型糖尿病患者腓肠肌痉挛与踝肱指数(ABI)的关系。方法·选择2型糖尿病患者300例,根据有无腓肠肌痉挛分为阳性组(n=70)和阴性组(n=230),分别检测各组血糖、血脂、血电解质、ABI和下肢血管彩色超声等,进行单一因素方差分析和χ2检验,采用多因素非条件Logistic回归分析2型糖尿病患者腓肠肌痉挛的危险因素。结果·12型糖尿病腓肠肌痉挛阳性组的空腹血糖(FBG)、三酰甘油(TAG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、吸烟率、下肢动脉硬化和下肢动脉斑块的发生率显著高于阴性组(P<0.05)。ABI在腓肠肌痉挛阳性组显著低于阴性组。2ABI<0.9的2型糖尿病患者的腓肠肌痉挛发生率显著高于ABI正常组和ABI>1.3组。3低ABI、高血糖、高胆固醇血症、高低密度脂蛋白胆固醇血症、吸烟、下肢动脉硬化、下肢动脉斑块是2型糖尿病患者腓肠肌痉挛的危险因素,非痛性糖尿病神经病变不引起糖尿病患者腓肠肌痉挛发生率的增加。结论·2型糖尿病患者腓肠肌痉挛和下肢动脉病变、吸烟、高血糖、高血脂有关。2型糖尿病患者一旦出现腓肠肌痉挛,应行ABI检查了解有无下肢动脉病变。

Objective·To investigate the association between ankle-brachial index （ABI） and gastrocnemius muscle spasm in patients with type 2 diabetes mellitus （T2DM）. Methods·Three hundred patients with T2DM were assigned to the positive group （n=70） and the negative group （n=230） according to the presence of gastrocnemius muscle spasm. Indexes such as blood glucose, blood lipids, blood electrolytes, and ABI were measured and color doppler ultrasound for lower extremity blood vessels was performed. One-way analysis of variance and Chi-square test were conducted. The risk factors for gastrocnemius muscle spasm in patients with T2DM were analyzed using multivariate non-conditional Logistic regression. Results·①Fasting blood glucose, triglyceride, total cholesterol, low-density lipoprotein cholesterin, smoking rate, and incidences of lower extremity arteriosclerosis and lower extremity arterial plaque in patients with T2DM were significantly higher in the positive group than in the negative group （P〈0.05）. ABI was significantly lower in the positive group than in the negative group. ②The incidence of gastrocnemius muscle spasm was significantly higher in T2DM patients with ABI〈0.9 than in those with normal ABI or ABI〉1.3. ③Low ABI, hyperglycemia, high cholesterol, high low-density lipoprotein cholesterol, smoking, lower extremity arteriosclerosis, and lower extremity arterial plaques were risk factors for gastrocnemius muscle spasm in patients with T2DM. Non painful diabetic neuropathy did not cause an increase in the incidence of gastrocnemius muscle spasm in diabetic patients. Conclusion·Gastrocnemius muscle spasm in patients with T2DM is associated with lower extremity arterial disease, smoking, hyperglycemia, and hyperlipidemia. Once patients with T2DM develop gastrocnemius muscle spasm, ABI examination should be performed to detect lower extremity arterial disease.