摘要
目的通过踝肱指数(ABI)检查,探讨住院糖尿病患者下肢外周动脉病变(PAD)的患病率,并分析影响ABI的危险因素。方法纳入华西医院内分泌科2004年8月～2006年12月住院糖尿病患者665例,使用多普勒血管超声仪检测ABI,同时检测血小板、血脂、尿酸、HbA1c和纤维蛋白原(Fib)等;通过回归分析探讨影响ABI的危险因素。结果665例糖尿病患者中,ABI降低组(ABI<0.9)107例(16.1%);ABI升高组(ABI≥1.3)51例(7.7%);ABI及PBI均正常者(0.9≤ABI<1.3)516例(76.2%)。与ABI正常者相比,ABI降低组患者年龄更大,病程更长,收缩压、血尿酸、TC、LDL-C、血小板、Fib更高;多因素logistic逐步回归分析显示年龄、血小板数和Fib水平是导致ABI降低的独立危险因素;而病程和LDL-C是导致ABI升高的危险因素。结论通过ABI检测发现,大约23.8%的住院糖尿病患者存在PAD;合并糖尿病PAD的患者血压、血脂以及尿酸代谢紊乱更为明显,且合并血液高凝状态。因此,对门诊和住院糖尿病患者,应常规进行ABI检测以早期发现糖尿病PAD;严格控制血压、血脂、尿酸以及改善高凝状态对于预防糖尿病PAD至关重要。
Objective To investigate the prevalence of peripheral arterial disease （PAD） of lower limbs in the hospitalized diabetic patients and analyze the risk factors relevant to ankle brachial index （ABI）. Methods 665 diabetic patients admitted during August 2004 to December 2006 were enrolled in this study. ABI and PBI（pedal-brachial pressure index） assessments were performed using hand-held Doppler Ultrasound in all of the subjects. Blood pressure, biochemistry profiles, blood counting, HbA1c, and coagulation function were measured. Multi-factorial logistic stepwise regressison analysis was used to screen the risk factors of ABI. Results Of the 665 diabetic patients, 107 （16.1%） patients had their ABI（0.9, 51（7.7%）had ABI≥1. 3 and 516 （76.2%）had normal ABI levels （0.9≤ABI〈1.3）. Comparred with those in the normal ABI group, patients with ABI（0.9 had older age, longer course, higher levels of systolic blood pressure, serum uric acid, cholesterol, LDL-C, platelet count and fibrinogen. Age, platelet count, total cholesterol and plasma fibrinogen were the independent risk factors for decreased ABI by logistic stepwise regression. Course of disease and LDL-C were the risk factors for ABI≥1. 3. Conclusion 1. About 23. 8% hospitalized diabetic patients accompany with PAD. 2. Diabetic patients with PAD have signifieant metabolic disturbance and hypercoagulated state. So it may be necessary to routinely deteet ABI for PAD. And it is very important to strictly control hypertension, dyslipidemia, hyperglycemia,hyperuricacidemia and hyper-coagulation.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2007年第11期643-646,共4页
Chinese Journal of Diabetes
关键词
糖尿病
踝肱指数
外周动脉病变
Diabetes mellitus
Ankle braehial index
Peripheral arterial disease
