2型糖尿病患者下消化道症状与糖尿病视网膜病变和下肢动脉病变相关性研究

Relationship between lower gastrointestinal tract symptoms and diabetic retinopathy and lower extremity artery disease in patients with type 2 diabetes mellitus

目的:探讨2型糖尿病患者下消化道症状与糖尿病视网膜病变和下肢动脉病变的相关性。方法:回顾性分析2016年8月至2018年3月在胜利油田中心医院128例2型糖尿病患者的临床资料。记录患者的一般临床资料和实验室检查指标,采用下消化道症状评定量表(LGSRS)进行评分,LGSRS评分≥ 6分为阳性组,LGSRS评分<6分为阴性组。行眼底和下肢彩色多普勒超声检查诊断糖尿病视网膜病变和糖尿病下肢动脉病变。Logistic回归分析评估LGSRS评分与糖尿病视网膜病变和下肢动脉病变的相关性。结果:阳性组66例,阴性组62例。阳性组年龄、糖尿病病程、LGSRS评分和糖尿病下肢动脉病变发生率明显高于阴性组[(64.24 ± 10.43)岁比(59.57 ± 12.50)岁、(14.67 ± 1.28)年比(10.98 ± 1.25)年、(8.65 ± 2.38)分比(2.77 ± 1.49)分和98.48%(65/66)比69.35%(43/62)],差异有统计学意义( P<0.05或<0.01);两组性别构成、体质量指数、糖化血红蛋白、空腹血糖、餐后2 h血糖、三酰甘油、总胆固醇和糖尿病视网膜病变发生率比较差异无统计学意义( P>0.05)。校正年龄、糖尿病病程、糖化血红蛋白、空腹血糖、三酰甘油、总胆固醇等混杂因素后,LGSRS评分与糖尿病下肢动脉病变呈正相关性( OR =1.174,95% CI 1.065~1.470, P = 0.001),而LGSRS评分与糖尿病视网膜病变无相关性( P = 0.313)。 结论:在2型糖尿病患者中,下消化道症状与糖尿病下肢动脉病变独立正相关,与糖尿病视网膜病变无相关性,提示下消化道症状与糖尿病下肢动脉病变之间可能存在共同的中小动脉病变的病理机制。

Objective To explore the correlation between lower gastrointestinal tract symptoms and diabetic retinopathy and lower extremity artery disease in patients with type 2 diabetic mellitus.Methods The clinical data of 128 patients with type 2 diabetic mellitus from August 2016 to March 2018 in Central Hospital of Shengli OilField were retrospectively analyzed.The general clinical data and laboratory indexes were recorded.The score was evaluated by lower gastrointestinal symptoms rating scale(LGSRS).Patients with the LGSRS score≥6 scores were as positive group,and those with LGSRS score<6 scores were as negative group.Fundus photography and ultrasonic scanning of lower extremity artery disease were performed for each patient.The correlation between LGSRS score and diabetic retinopathy,lower extremity artery disease was analyzed by Logistic regression.Results Positive group had 66 cases,and negative group had 62 cases.The age,duration of diabetic,LGSRS score and incidence of diabetic retinopathy in positive group were significantly higher than those in negative group:(64.24±10.43)years vs.(59.57±12.50)years,(14.67±1.28)years vs.(10.98±1.25)years,(8.65±2.38)scores vs.(2.77±1.49)scores and 98.48%(65/66)vs.69.35%(43/62),and there were statistical differences(P<0.05 or<0.01).There were no statistical difference in gender,body mass index,glycated hemoglobin,fasting blood glucose,2 h postprandial blood glucose,triglyceride,total cholesterol and incidence of diabetic retinopathy between 2 groups(P>0.05).After adjusting for age,duration of diabetic,glycated hemoglobin,fasting blood glucose,triglyceride and total cholesterol,the LGSRS score showed positive correlation with diabetic lower extremity artery disease(OR=1.174,95%CI 1.065 to 1.470,P=0.001),but there was no correlation between LGSRS score and diabetic retinopathy(P=0.313).Conclusions In patients with type 2 diabetes mellitus,lower gastrointestinal tract symptoms has positive correlation with diabetic lower extremity artery disease,and no correlation with diabetic retinopathy.It suggests that there may be a common pathological mechanism between lower gastrointestinal tract symptoms and diabetic lower extremity artery disease.