老年2型糖尿病患者下肢血管病变的危险因素分析

Analysis of risk factors of lower extremity arterial disease in elderly patients with type 2 diabetes mellitus

目的探讨老年2型糖尿病患者下肢血管病变的危险因素,为临床早期有效防治糖尿病足及心、脑血管疾病提供依据。方法选取2015年10月~2017年4月在承德医学院附属医院280例老年2型糖尿病患者,根据下肢血管彩色多普勒超声检查结果分为对照组和病例组,每组140例。比较两组患者一般情况、吸烟史、患病情况及实验室检查指标的差异,分析老年2型糖尿病患者下肢血管病变的危险因素。结果多因素Logistic回归分析结果显示:收缩压(SBP)(OR=2.195,95%CI:1.085~3.530)、低密度脂蛋白胆固醇(LDL-C)(OR=1.900,95%CI:1.170~3.129)、血浆同型半胱氨酸(Hcy)(OR=1.677,95%CI:1.178~2.410)、三酰甘油(TG)(OR=1.510,95%CI:1.122~1.950)、糖化血红蛋白(HbA_(1c))(OR=1.362,95%CI:1.000~1.860)是老年2型糖尿病患者下肢血管病变的危险因素。结论伴有高SBP、高LDL-C、高Hcy、高TG、高HbA_(1c)的老年2型糖尿病患者更容易发生下肢血管病变。

Objective To explore the risk factors of lower extremity arterial disease in elderly patients with type 2 diabetes mellitus, so as to provide the basis for early clinical prevention and treatment of diabetic foot and heart, cerebrovascular disease. Methods From October 2015 to April 2017, 280 cases of elderly patients with type 2 diabetes mellitus in Affiliated Hospital of Chengde Medical College were selected, they were divided into control group and case group according to lower extremity blood vessel color Doppler ultrasonography results, each group of 140 cases. The differences of general, smoking history, prevalence of disease and laboratory indicators between the two groups were compared, the risk factors of lower extremity arterial disease of elderly patients with type 2 diabetes mellitus were analyzed. Results Multivariate Logistic regression analysis showed that： systolic blood pressure（SBP）（OR=2.195, 95%CI：1.085-3.530）, low density lipoprotein cholesterol（LDL-C）（OR =1.900, 95% CI： 1.170-3.129）, plasma homocysteine（Hcy）（OR=1.677, 95%CI： 1.178-2.410）, triglyceride（TG）（OR=1.510, 95%CI： 1.122-1.950）, glycosylated hemoglobin（HbA_（1c））（OR=1.362, 95%CI： 1.000-1.860） were the risk factors of lower extremity arterial disease of elderly patients with type 2 diabetes mellitus. Conclusion Elderly patients with type 2 diabetes mellitus are more likely to develop lower extremity arterial disease with high SBP, high LDL-C, high Hcy, high TG, and high HbA_（1c）.