2型糖尿病患者下肢动脉硬化的影响因素分析

Analysis of influencing factors of lower extremity arteriosclerosis in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者合并下肢动脉硬化(LEA)的独立影响因素。方法回顾性分析2021年1月至2022年12月华中科技大学同济医学院附属梨园医院创面修复中心收治的420例T2DM患者资料,其中275例患者合并LEA,145例患者无LEA。收集性别、年龄、基础疾病(包括冠心病、脑梗死、高血压、高脂血症)、D-二聚体、白细胞数(WBC)、红细胞数(RBC)、血红蛋白(HGB)、空腹血糖、糖化血红蛋白(HbA1c)、补体C1q、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、B型脑钠肽(BNP)等指标,分析与T2DM患者合并LEA密切相关的影响因素。数据分析采用t检验、Mann-Whitney U检验、χ2检验,以及logistic回归分析。结果收集420例T2DM患者,275例合并LEA,发生率为65.5%,其余145例患者无LEA。是否合并LEA的患者比较发现,冠心病、脑梗死、D-二聚体、HGB、HbA1c、HDL-C、LDL-C、BNP可能与LEA发生有关(P<0.05),其余变量两组比较差异无统计学意义(P>0.05)。单因素logistic回归分析结果显示,冠心病、D-二聚体、HbA1c、LDL-C、BNP可能是LEA的影响因素(P<0.05)。进一步建立多元logistic回归模型发现,有冠心病、D-二聚体高、HbA1c高和BNP高是T2DM患者发生LEA的独立影响因素(P<0.05)。结论合并冠心病、D-二聚体高、HbA1c高或BNP高是T2DM患者合并LEA的独立影响因素。

Objective To explore the risk factors of lower extremity arteriosclerosis(LEA)in T2DM patients.Methods Data of 420 patients with T2DM admitted to Wound Repair Center,Liyuan hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2021 to December 2022 were retrospectively reviewed including 275 patients with LEA and 145 patients without LEA.The data of gender,age,basic diseases(including coronary heart disease,cerebral infarction,hypertension,hyperlipidemia),D-dimer,white blood cell count(WBC),red blood cell count(RBC),hemoglobin(HGB),fasting blood glucose,glycated hemoglobin(HbA1c),complement C1q,alanine transaminase(ALT),aspartate transaminase(AST),triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)and brain natriuretic peptide(BNP)indicators were collected and analyzied.Data were analyzed by t test,Mann-Whitney U test,chi-square test and logistic regress analysis.Results Among 420 patients with T2DM,275 patients had LEA with the incidence rate of 65.5%,and the remaining 145 patients did not have LEA.Compared between the patients with LEA or not,it was found that coronary heart disease,cerebral infarction,D-dimer,HGB,HbA1c,HDL-C,LDL-C and BNP were posiblely related with LEA in T2DM patients(P<0.05),while the other variables had no statistical significance between the two groups(P>0.05).Univariate logistic regression analysis showed that coronary heart disease,D-dimer,HbA1c,LDL-C and BNP were the influencing factors of LEA(P<0.05).The multivariate logistic regression analysis showed that coronary heart disease,high D-dimer,high HbA1c and high BNP were independent risk factors for T2DM patients with LEA(P<0.05).Conclusion Coronary heart disease,high D-dimer,high HbA1c and high BNP are independent risk factors for T2DM patients with LEA.