2型糖尿病患者踝肱指数与脑梗死的相关性分析

Correlation analysis of ankle-brachial index and cerebral infarction in patients with type 2 diabetes mellitus

目的测定2型糖尿病(T2DM)患者合并与非合并脑梗死患者的踝肱指数(ABI),探讨ABI与T2DM合并脑梗死的相关性。方法选取2016年1月至2017年1月在安徽医科大学第一附属医院内分泌科住院的358例T2DM患者为研究对象。按是否合并脑梗死将患者分为T2DM组182例和T2DM合并脑梗死(T2DM+CI)组176例,测定两组患者的ABI,记录和收集患者一般情况、血糖及生化常规等相关资料。采用Pearson相关分析、多元线性回归分析以及logistic回归分析进行临床资料以及脑梗死与ABI的相关性分析。结果 T2DM组与T2DM+CI组ABI分级差异有统计学意义,且T2DM+CI组中ABI分级B组和C组比例显著高于T2DM组(P均<0.05)。Pearson相关分析显示,ABI与年龄、糖尿病病程、收缩压、空腹血糖、HbA1c呈负相关(r值分别为-0.230、-0.152、-0.108、-0.120、-0.143,P均<0.05);多元线性回归分析显示,年龄、糖尿病病程、收缩压是ABI的独立危险因素;logistic回归分析显示,与正常ABI患者相比,轻度梗阻患者、中-重度梗阻患者脑梗死的患病风险均增加(OR值分别为1.34、2.23,P均<0.05)。结论 T2DM患者脑梗死的发病风险与ABI降低密切相关。

Objective To determine the ankle-brachial indexes(ABI)of those patients with type 2 diabetes mellitus(T2DM),uncomplicated or complicated with cerebral infarction(CI),and to investigate the correlation between ABI and T2DM patients with CI.Methods From Jan 2016 to Jan 2017,358 cases of T2DM inpatients hospitalized in our hospital were collected as the study objectives,and were divided into the T2DM group(n=182)and the T2DM+CI group(n=176)according to their complications with or without CI.Then the ABI scores and other related clinical data in the two groups,such as general conditions,blood glucose levels and biochemical examinations,were detectedand recorded.And the correlation analysis of their clinical characteristics and their ABI and CI were performed by means of Pearson analysis,multivariate linear regression analysis and logistic regression analysis.Results There was significant difference between the T2DM group and the T2DM+CI group in the ABI grades,and the proportions of grade B and C of the ABI grades in the T2DM+CI group were significantly higher than those in the T2DM group(P<0.05).Pearson correlation analysis showed that ABI was significantly negatively correlated with age,duration of diabetes,systolic blood pressure(SBP),fasting blood glucose and HbA1c(rvalues of-0.230,-0.152,-0.108,-0.120,-0.143,respectively;all P<0.05).Multiple linear regression analysis showed that age,duration of diabetes and SBP were independent risk factorsof ABI.Logistic regression analysis showed that the CI risk was significantly increased in those patients with mild stenosis or moderate to severe stenosis when compared to the patients with normal ABI(OR values of 1.34,2.23,respectively;P<0.05).Conclusion The risk of cerebral infarction in T2DM patients may be closely associated with the reduction of ABI scores.