社区糖尿病患者周围动脉病变的患病情况及危险因素

The Prevalence of Peripheral Arterial Disease and Its Risk Factors among Patients with Type 2 Diabetes in Community

目的了解社区2型糖尿病患者并发周围动脉病变(PAD)的患病率,探讨其相关危险因素,为社区有针对性地进行早期干预提供参考.方法选取2014年6月至2015年6月深圳市某社区已确诊2型糖尿病患者662例,根据踝肱动脉指数检测(ABI<0.9)分为并发PAD组和无PAD组,统计患病率并采用单因素分析和多因素Logistic回归分析确定独立危险因素.结果 25.83%(171/662)的糖尿病患者并发周围动脉病变.单因素分析结果表明年龄、受教育程度、糖尿病家族史、糖尿病病程、吸烟、运动、膳食习惯、荤素搭配、体质指数(BMI)、共患高血压、高血脂、结核病与PAD发病风险显著关联(P<0.05).多因素Logistic回归结果发现,高龄、共患高血压、糖尿病病程久、血脂异常、BMI高、有糖尿病家族病史、吸烟是糖尿病患者并发PAD的独立危险因素(P<0.05).经常运动和高教育水平是抑制PAD发生发展的保护因素(P<0.05).结论社区2型糖尿病人群中PAD患病率较高,危险因素也较多.医务人员应充分重视并加强社区PAD的早期筛查及针对性地预防,指导糖尿病患者在控制血糖的同时应严格控制其血压、调节血脂水平,控制体质指数及倡导戒烟,尤其对于高龄、病程较长、有糖尿病家族史的患者,以有效降低PAD的患病率.

Objective To investigate the prevalence and explore the related risk factors for peripheral arterial disease(PAD)among patients with type 2 diabetes so as to provide the evidence and reference to the early intervention in community.Methods A total of 662 patients with type 2 diabetes were selected in the community from June 2014 to June 2015 in Shenzhen province.All patients were divided into two groups according to the values of ankle-brachial index.The prevalence of PAD was calculated.Univariate and logistic regression analysis was applied to explore risk factors associated with the prevalence of PAD.Results 25.83%(171/662)of the diabetic patients suffered fromperipheral arterial disease.Univariate analysis results found that age,education level,family history,course of disease,smoking status,physical exercise,dietary habits,body mass index,with hypertension,with hyperlipidemia,tuberculosis were all significantly associated with the prevalence of PAD(<0.05).Logistic regression analysis finally showed that older age,with hypertension,with dyslipidemia,long course of disease,body mass index,with family history,smoking were found to be the valuable risk factors related to PAD(<0.05),whereas high education level and regular physical exercise were protective factors against PAD(<0.05).Conclusions Among diabetic patients in community,the prevalence of PAD was higher and there were many risk factors.We suggest that the early screening of PAD and targeted intervention should be given full attention and strengthened.Based on controlling of blood glucose,diabetic patients should not only strictly control blood pressure,but also pay attention to blood lipid regulation,control BMI and ensure smoking cessation,especially for those with advanced age,long course of disease and family history,so that we can effectively reduce the prevalence of PAD.