2型糖尿病对不同冠状动脉类型患者下肢动脉硬化狭窄程度的影响

Influence of type 2 diabetes mellitus on lower limb arteriosclerosis in patient with different types of coronary artery lesion

目的探讨2型糖尿病对不同冠状动脉类型患者下肢动脉硬化闭塞情况的影响。方法选择2013年1月至2018年10月在本院行冠状动脉造影检查的患者200例,按冠脉造影结果分为非冠心病组(50例)和冠心病组(150例),其中冠心病组又根据冠脉病变支数分为单支病变、两支病变、三支病变,每组各50例。分析各冠心病组患者2型糖尿病与下肢动脉硬化狭窄程度及下肢动脉踝肱动脉压力指数(AAI)的关系。结果无糖尿病患者中各组下肢动脉硬化闭塞发生率差异无统计学意义;而2型糖尿病患者中各组间下肢动脉硬化闭塞发生率差异有统计学意义(P<0.05);2型糖尿病患者中,两支病变组和三支病变组下肢动脉闭塞阳性率明显高于对照组(P<0.05)。2型糖尿病患者的下肢动脉AAI明显低于无糖尿病患者(P<0.05);冠心病不同病变支数的患者间AAI比较,差异有统计学意义(P<0.01)。2型糖尿病和冠心病均能降低下肢动脉AAI(P<0.05);进一步析因分析表明,2型糖尿病和冠心病在影响下肢动脉AAI方面存在交互作用(P<0.05),两者同时存在,对AAI值影响更大。结论下肢动脉硬化的发生与2型糖尿病及冠心病均有关联,2型糖尿病和冠心病若同时存在,其下肢动脉硬化的发生可能性越大。

Objective To discuss the effect of type 2 diabetes mellitus on lower extremity arteriosclerosis occlusion in patients with different types of coronary artery.Methods 200 patients who underwent coronary angiography were divided into non-coronary heart disease group(n=50)and coronary heart disease group(n=150)according to the results of coronary angiography.The patients in the coronary heart disease group were divided into single lesion group,two lesion group and three lesion group according to the number of coronary lesion branches,with 50 cases in each group.To analyze the relationship between type 2 diabetes mellitus and lower extremity arteriosclerosis stenosis and ankle/arm blood pressure index(AAI)in each coronary heart disease group.Results There was no significant difference in the incidence of lower extremity arteriosclerosis occlusion among the groups without diabetes mellitus,but there was significant difference in the incidence of lower extremity arteriosclerosis occlusion among the groups with type 2 diabetes mellitus(P<0.05).Patients with type 2 diabetes mellitus,the positive rate of lower extremity artery occlusion in two-vessel lesion group and three-vessel lesion group was significantly higher than that in control group(P<0.05).AAI of lower limb arteries in type 2 diabetes mellitus patients was significantly lower than that in non-diabetic patients(P<0.01),and there was significant difference in AAI between patients with different lesion branches of coronary heart disease(P<0.01).Type 2 diabetes mellitus and coronary heart disease can reduce AAI.Further factorial analysis shows that type 2 diabetes mellitus and coronary heart disease have interaction in affecting AAI of lower extremity arteries(P<0.05),both of them exist at the same time,and have greater impact on AAI value.Conclusion The occurrence of lower extremity arteriosclerosis is associated with type 2 diabetes mellitus and coronary heart disease.If type 2 diabetes mellitus and coronary heart disease exist simultaneously,the occurrence of lower extremity arteriosclerosis is more likely.