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2型糖尿病患者合并下肢动脉疾病多因素分析

李文静   

  1. 天津医科大学代谢病医院
  • 收稿日期:2011-01-21 修回日期:2011-04-01 出版日期:2011-11-15 发布日期:2011-11-15
  • 通讯作者: 李文静

Multi-Factor Analysis of Peripheral Arterial Disease in Patients with Type 2 Diabetes

Wen-Jing LI   

  • Received:2011-01-21 Revised:2011-04-01 Published:2011-11-15 Online:2011-11-15
  • Contact: Wen-Jing LI

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摘要： 摘要 目的：探讨2型糖尿病（T2DM）患者合并下肢动脉病变程度的影响因素。方法：对455例住院的T2DM患者行下肢多普勒超声检查，根据下肢动脉超声检查结果分为对照组109例、轻度狭窄组（狭窄<30%）113例、中度狭窄组（30%≤狭窄<70%）118例、重度狭窄组（>70%组）115例，分析各组下肢动脉疾病程度及其影响因素。结果：重度狭窄组的年龄、病程、体质指数（BMI）、腰围（WC）、腰臀比（WHR）、腰围身高比（WHtR）、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇（LDL-C）、收缩压（SBP）、糖化血红蛋白（HbA1c）均高于轻、中度狭窄组与对照组，差异有统计学意义（P<0.01或P<0.05），中、重度狭窄组的高密度脂蛋白胆固醇（HDL-C)低于轻度狭窄组、对照组，差异有统计学意义（P<0.01或P<0.05）；下肢动脉病变与WHtR、HbA1c、病程、年龄、LDL-C、WC、SBP呈正相关（P<0.01），与HDL-C呈负相关（P<0.01）；多项Logistic回归分析显示，WHtR、HbA1c、LDL-C升高均为下肢动脉病变发生的的独立危险因素（P<0.01或P<0.05），HDL-C升高为下肢动脉的保护因素（P<0.05）。结论:WHtR可能为预测T2DM患者合并外周动脉疾病的一项经济、简便、有效的人体测量学指标。

关键词: 糖尿病, 2型, 糖尿病血管病变, 下肢, 超声检查, 多普勒, 彩色

Abstract: Abstract Objective: To explore the risk factors for the severity of angiographic peripheral arterial disease (PAD) in patients with type 2 diabetes (T2DM). Methods: Four hundred and fifty-five hospitalized T2DM patients were divided into four groups according to color Doppler ultrasound of lower limb, including 109 patients without stenosis (control group), 113 patients with stenosis<30% (mild stenosis group), 118 patients with 30%≤stenosis<70% (moderate stenosis group) and 115 patients with stenosis>70% (severe stenosis group). The risk factors were analysed in subjects of groups. Results: There were significantly higher values of age, course of disease, body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), waist-height ratio (WHtR), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL-C), systolic blood pressure (SBP) and glycosylated hemoglobin (HbA1c) in patients of severe stenosis group than those of other groups (P<0.01 or P<0.05). The level of high-density lipoprotein (HDL-C) was lower in patients of moderate stenosis group and severe stenosis group than that of mild stenosis group and control group (P<0.01 or P<0.05). There was a positive correlation between peripheral arterial diseases of lower limb and WHtR, HbA1c, course of disease, age,LDL-C,WC and SBP (P<0.01), but a negative correlation between peripheral arterial diseases of lower limb and HDL-C. Logistic regression analysis showed that values of WHtR, HbA1c and LDL-C were independent risk factors for the severity of angiographic peripheral arterial disease (P<0.01 or P<0.05). The increased level of HDL-C was the protective factor for the arterial diseases of lower limb (P<0.05). Conclusion: WHtR might be an easy and efficient anthropometric index for prognosis of PAD in patients with T2DM.

Key words: diabetes mellitus, type 2diabetic angiopathieslower extremityultrasonography, doppler, colorlipidsbody weights and measuresLogistic modelswaist to height ratio, 彩色