应用多普勒血流探测仪评估踝肱指数与2型糖尿病患者发生大血管病变的相关性  

Correlation between ankle brachial index and the incidence of great blood vessel pathological changes in patients with type 2 diabetes mellitus:Evaluation using Doppler detector

作　　者：王熙然[1] 裴育[1] 李全民[1] 张帆[1] 张丽娅[1] 吴艳丹[1] 陈艳梅[2] 朱艳秋[1] 詹志伟[1] 邵伟庆[1] 

机构地区：[1]解放军第二炮兵总医院内分泌科,北京市100088 [2]解放军北京军区总医院干部病房1科,北京市100700

出　　处：《中国组织工程研究与临床康复》2008年第4期659-662,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:分析踝肱指数与2型糖尿病患者发生大血管并发症的相关性,验证踝肱指数作为评价或预测糖尿病大血管病变简易指标的可能性。方法:对2006-04/2007-04在解放军第二炮兵总医院住院的2型糖尿病患者213例资料进行回顾性分析。糖尿病诊断均符合ADA(1997)标准,其中男性108例,女性105例;年龄25～86岁,平均(60.5±12.9)岁;病程1～600个月。采用日本林电器株式会社制造的ES-1000SPM多普勒血流探测仪测定踝肱指数。患者入院后第1天清晨空腹均进行身高、体质量、血压测量,计算体质量指数,行糖化血红蛋白、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、尿素氮、肌酐、尿酸、尿微量白蛋白、踝肱指数、眼底检查,常规12导联心电图检查。将所有患者以踝肱指数比值大小分2组,分别为踝肱指数<0.9组29例和踝肱指数≥0.9组184例。结果:213例2型糖尿病患者中,周围动脉闭塞性疾病的发病率为13.6%,性别方面差异无显著性。踝肱指数<0.9组患者年龄大,病程长,合并糖尿病肾病、冠心病、脑梗死率高于踝肱指数≥0.9组,差异有显著性意义(P<0.05)。踝肱指数与年龄、糖尿病病程、糖化血红蛋白、低密度脂蛋白胆固醇呈负相关(P<0.05)。logistic回归显示年龄、糖尿病病史、脑梗死是踝肱指数的独立危险因子。结论:踝肱指数与2型糖尿病患者大血管病变发生率密切相关,是2型糖尿病患者进行周围动脉闭塞性疾病初筛的有效指标。AIM： To analyze the correlation between ankle brachial index （ABI） and the incidence of great blood vessel pathological changes in type 2 diabetes mellitus patients, so as to verify if ABI could serve as the simple index to evaluate or predict the great blood vessel pathological changes in type 2 diabetes mellitus. METHODS： 213 inpatients with type 2 diabetes in the General Hospital of Second Artillery Forces from April 2006 to April 2007 were retrospectively analyzed. Diabetes diagnosis was complied with the ADA （1997）. There were 108 males, and 105 females, averagely aged （60.5±12.9） years （range, 25 to 86 years）; the course of illness was 1-600 months. ABI was measured by ES-1000SPM Doppler detector （Japan）. On the first morning of hospitalization, the height, body mass, and blood pressure were detected to calculate body mass index, glycosylated hemoglobin, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, blood urea nitrogen, creatinine, uric acid, urinary microalbuminuria protein, ankle brachial index. Meanwhile, eye ground examination and conventional 12-lead ECG were performed. All patients were divided into two groups according to their ABI： ABI 〈 0.9 group （n =29） and ABI ≥ 0.9 group （n =184）. RESULTS： Among 213 diabetic patients, the prevalence of peripheral arterial occlusion disease was 13.6%, with no significant sexual difference. ABI lower than 0.9 group showed older age, longer diabetes duration, and higher occurrence of diabetic nephropathy, coronary artery disease and cerebral infarction （P 〈 0.05）. ABI was negatively correlated with age, duration of diabetes, glycosylated hemoglobin, and low-density lipoprotein cholesterol levels （P 〈 0.05）. The results of multivariate logistic regression analysis indicated that age, diabetes duration, and cerebral infarction are independent risk factors for ABI. CONCLUSION： ABI is closely correlated with the incidence of great blood vessel path

关 键 词：踝肱指数 2型糖尿病 大血管病变 

分 类 号：R587.1[医药卫生—内分泌]