社区糖尿病及糖调节受损人群周围血管病变的患病率调查  

Prevalence of peripheral vascular disease in diabetics and impaired glucose regulation subjects: a community-based study

作　　者：沈琴[1] 贾伟平[1] 包玉倩[1] 陆俊茜[1] 陆惠娟[1] 左玉华[2] 杜颉 刘兰花[2] 方蓉[2] 

机构地区：[1]上海市糖尿病临床医学中心,上海市糖尿病研究所上海交通大学附属第六人民医院内分泌代谢科,200233 [2]上海市曹杨社区卫生服务中心

出　　处：《中华医学杂志》2006年第22期1530-1533,共4页National Medical Journal of China

基　　金：上海市科学技术委员会重大资助项目(04dz19501)

摘　　要：目的了解上海社区糖尿病及糖调节受损（IGR）人群周围血管病变（PVD）的患病率及其主要危险因素.方法对2000-2001年间上海市曹杨社区代谢综合征流行病学调查获得的糖尿病及IGR患者（717例）进行5年后的随访,将其中完成随访并具有完整数据者427例纳入本次分析,其中男性210例,女性217例,年龄21～104岁（67.3岁±14.0岁）.PVD采用Nicolet Versalab SE双向多普勒血流探测仪检测踝/肱动脉压比值（A/BI）进行诊断,同时采用爱丁堡跛行问卷调查间歇性跛行.对与PVD有关的各影响因素进行Logistic回归分析.结果曹杨社区高血糖人群PVD患病率为12.2%,其中在糖尿病人群中为15.1%,在IGR人群中为7.7%.在ABI≤0.9患者中仅13.5%出现间歇性跛行症状.Logistic回归分析发现,年龄、性别、糖尿病病程及总胆固醇是糖尿病周围血管病变的独立危险因素.结论上海社区高血糖人群中PVD患病率较高,不仅发生于糖尿病阶段,而且在糖尿病前期即已出现.大多数PVD患者无临床症状,因此在糖尿病门诊常规进行多普勒ABI检测有助于PVD的早期诊断、早期干预.Objective To investigate the prevalence of peripheral vascular disease （PVD） in patients with diabetes mellitus （DM） and impaired glucose regulation （IGR）. Methods Follow-up 5 years after the previous epidemiologic study of metabolic syndrome in Chaoyang community, Shanghai, 2000 - 2001 was conducted among 717 patients with DM or IGR. Questionnaire survey about general status and DM- related history and behaviors, including smoking, was carried out. Physical examination was made. Ankle/ brachial index （A/BI） was measured. Intermittent claudication was surveyed by Edinburgh claudication questionnaire （ECQ）. Blood sugar and blood lipid were detected. 427 patients, 210 males and 217 females, aged 67.3 ± 14.0 （21 - 104）, with intact data were enrolled into the analysis. Results The overall prevalence of PVD was 12. 2% in the hyperglycemic population. The prevalence of PVD in the diabetics was 15.1%, significantly higher than that of the IGP subjects （7.7%, P =0. 022）. The rate of intermittent claudication in those with the A/BI ≤0.9 was 13.5%. Logistic regression revealed that age, sex, diabetic duration, and total cholesterol were independent risk factors of diabetic PVD. Conclusion The PVDprevalence is rather high in both diabetics and IGR subjects. Most PVD patients are asymptomatic. AB/I measurement helps early diagnosis of PVD.

关 键 词：周围血管病变 糖尿病 踝/肱动脉压比值 

分 类 号：R587.2[医药卫生—内分泌] R473.2[医药卫生—内科学]