老年2型糖尿病患者纤维蛋白原和PR间期与下肢动脉硬化闭塞症的关系

Relationship between fibrinogen,PR interval and lower extremity arteriosclerosis obliterans in elderly patients with type 2 diabetes mellitus

目的探讨老年2型糖尿病(T2MD)患者纤维蛋白原(Fib)和PR间期与下肢动脉硬化闭塞症(ASO)的关系。方法收集老年T2DM合并下肢ASO患者106例(ASO组)和老年T2DM未合并下肢ASO患者122例(非ASO组)的Fib和PR间期等相关临床资料,采用logistic回归分析老年T2DM患者合并下肢ASO的影响因素,采用ROC曲线评价Fib和PR间期对老年T2DM患者合并下肢ASO的诊断效能。结果与非ASO组比较,ASO组年龄较大,T2DM病程和PR间期较长,男性、吸烟史、冠心病、糖尿病周围神经病变比例较高,白蛋白、HDL-C较低,Fib、尿酸、SCr、尿白蛋白/尿肌酐比值、C肽、Plt较高(P<0.05)。年龄较大、男性、有糖尿病周围神经病变、Fib较高、PR间期较长是老年T2DM患者合并下肢ASO的独立危险因素(P<0.05)。Fib和PR间期诊断老年T2DM患者合并下肢ASO的AUC分别为0.760和0.652(P<0.05);取最佳诊断界值分别为3.68 g/L和170 ms时,其对应的灵敏度为67.4%和50.6%,特异度为78.7%和72.1%。结论Fib和PR间期是老年T2DM患者合并下肢ASO的独立影响因素,且对老年T2DM患者合并下肢ASO有一定的诊断价值。

Objective To explore the relationship between fibrinogen(Fib),PR interval and lower extremity arteriosclerosis obliterans(ASO)in elderly patients with type 2 diabetes mellitus(T2DM).Methods The relevant clinical data including laboratory indicators and PR interval were collected in 106 elderly T2DM patients with lower extremity ASO(group ASO)and 122 elderly T2DM patients without lower extremity ASO(group C).Logistic regression analysis was used to analyze the influencing factors for lower extremity ASO in elderly T2DM patients,and ROC curve was used to evaluate the value of Fib and PR interval in diagnosing lower extremity ASO in elderly T2DM patients.Results Compared with group C,the patients of group ASO were older in age,had longer duration of T2DM and wider PR interval,and were with higher proportions of male,smoking history,coronary heart disease and diabetic peripheral neuropathy(P<0.05).The levels of albumin and HDL-C were lower,the levels of Fib,uric acid,SCr,C-peptide and Plt and the ratio of urinary albumin to urinary creatinine were higher in group ASO than those in group C(P<0.05).Older age,male,diabetic peripheral neuropathy,higher Fib and longer PR interval were the independent risk factors for lower extremity ASO in elderly T2DM patients(P<0.05).The AUC values of Fib and PR interval in diagnosing lower extremity ASO of elderly patients were 0.760 and 0.652,respectively.When the best cut-off values of Fib and PR interval were 3.68 g/L and 170 ms,the sensitivity were 67.4%and 50.6%,and the specificity were 78.7%and 72.1%,respectively.Conclusion The Fib and PR interval are the independent influencing factors for lower extremity ASO in elderly T2DM patients,which have a certain value in diagnosing lower extremity ASO.