初诊Ⅱ型糖尿病患者踝肱动脉指数危险因素分析  

Difference and analysis of ankle-brachial index in the middle aged and older patients with type 2 diabetes newly diagnosed

作　　者：曾立[1] 马绍刚[1] 黄永真[2] 

机构地区：[1]南昌大学第三附属医院内分泌科,330008 [2]宜春学院医学院,336000

出　　处：《中国保健营养（临床医学学刊）》2008年第3期1-3,共3页China Health Care Nutrtion

摘　　要：目的研究踝肱动脉血压指数（ABI）在初诊中老年2型糖尿病（T2DM）患者下肢动脉病变（PAD）中临床意义与影响因素。方法采用多普勒血流探测仪检测129例初诊中老年T2DM患者足背动脉、胫后动脉与肱动脉血压的比值，以0．9为切割点，分析比较中老年两组ABI及临床参数差别。结果129例初诊中老年T2DM患者中ABI〈0．9为14例。占总数10．9％，老年组ABI、吸烟率、甘油三酯低于中年组，而PAD患病率、BMI、收缩压、高血压患病率、高血压病程、空腹血糖、餐后2小时血糖、HbA1c高于中年组，差异有统计学意义（P〈0.05），ABI与年龄（r=-0．461，p=0.001）、高血压病程（r=-0．318，p=0．029）、HbA1c（r=-0.361，p=0．046）呈负相关，多元逐步回归分析显示年龄（p=0.02）、高血压病程（p=0.01）是ABI独立影响因素。结论初诊中老年T2DM中ABI〈0.9者占10．9％。老年组患病率及危险因素高于中年组，年龄、高血糖、高血压为PAD的主要危险因素。Objective To investigate ankle-brachial index（ABI） in the diagnosis of peripheral artery disease （PAD）and its risk factors in the the middle aged and older patients with type 2 diabetes newly diagnosed. Methods The 129 newly diagnosed（duration≤6 months）patients with type 2 diabetes were divided into group A（the middle aged , years 40-59） and group B（the older , years ≥60）.ABI and various parameters in two groups were examined and analysed by statistical methods. Results 14 patients （10. 9%） showed abnormal ABI （ABI〈0.9）, the older group had lower ABI （1.02±0. 14 vs 1.14±0.17）, fewer smokers （9. 3% vs 29. 7%）, lower levels serum triglycerides （1.7±1. lvs 2.7±2.4 mmol/L）,but more frequency of the patients with PAD（18. 5% vs 5.4%）, more hypertension（66% vs 39.1%）.There were higher body mass index （25. 5±3. 5 vs 24.8±2. 7 Kg/m^2） ,higher systolic blood pressure（141.9±19. 4 vs 128. 3±20. 0 mmHg）, longer duration of hypertension（37. 2±62. 4 vs 13. 2±22.8 months）,higher fasting plasma glucose（11.8±4. 4 vs 10. 3±3.6 mmol/L）, higher two-hour postprandial plasma glucose （18.3±5.8 vs 16. 4±5. 1 mmol/L）and higher levels of HbAlc （10.0±2. 9 vs 8. 4±2.1） in group B than in group A. ABI was in significant negative correlation with age, duration of hypertension and HbAlc. Step-wise analysis screened that age and duration of hypertension were the independent risk factors for PAD. Conclusions There are 10. 9% patients with lower ABI in the newly diagnosed middle aged and older patients type 2 diabetes. Aging, hyperglycemia and hypertension are important risk factors. It is easy and economical to mensurate ABI for diagnosing PAD in the newly diagnosed with type 2 diabetes.

关 键 词：糖尿病 Ⅱ型 初诊 踝肱动脉血压指数 危险因素 

分 类 号：R587.1[医药卫生—内分泌]