骨密度变化与2型糖尿病合并冠状动脉粥样硬化性心脏病患者踝肱指数的关系  

Relationship between bone mineral density and ankle brachial index in type 2 diabetes patients with coronary atherosclerotic heart disease

作　　者：王熙然[1] 裴育[2] 白玉蓉[1] 李全民[1] 张帆[1] 吴艳丹[1] 朱艳秋[1] 詹志伟[1] 邵伟庆[1] 陈艳梅[3] 

机构地区：[1]解放军第二炮兵总医院内分泌科,北京市100088 [2]解放军总医院老年内分泌科,北京市100853 [3]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20期3897-3900,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的：研究表明，动脉硬化与骨质疏松存在着共同的病理生理机制。实验拟分析2型糖尿病合并冠状动脉粥样硬化性心脏病（简称冠心病）患者踝肱指数与骨密度变化的特点。方法：①试验分组：回顾性分析2004—04／2007-04在解放军第二炮兵总医院住院的2型糖尿病患者503例，男272例，女231例；年龄25～86岁，平均（63±13）岁，病程1～600个月。均符合1997年美国糖尿病协会（ADA）的2型糖尿病诊断标准，排除卧床患者，踝肱指数〉1．4的患者。患者对治疗及试验均知情同意。所有患者以是否合并冠心病分为冠心病组和非冠心病组。②试验方法：患者入院后第1天晨起空腹行身高、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、眼底检查，常规12导联心电图检查。③试验评估：采用ES-1000SPM多普勒血流探测仪及美国NORLAND公司生产的双能X射线骨密度仪对503例2型糖尿病患者进行踝肱指数、腰椎（L2-4）、左侧股骨颈、大转子、华氏三角区骨密度测定。结果：纳入2型糖尿病患者503例，均进入结果分析。冠心病组231例，男106例，女125例；非冠心病组272例，男144例，女128例。两组相比，冠心病组患者年龄大，糖尿病病程长，体质量指数大，踝肱指数偏低，两组间差异显著（P〈0．05）。男性经过年龄、糖尿病病程、体质量指数校正后两组间股骨颈部位骨密度差异有显著性意义（P〈0.05）：女性经过年龄、糖尿病病程、体质量指数校正后，各部位的骨密度两组间差异无显著性意义（P〉0．05）。结论：①2型糖尿病合并冠心病患者较未患冠心病患者踝肱指数偏低。②男性2型糖尿病合并冠心病患者股骨颈部位骨密度偏低；女性2型糖尿病合并冠�AIM： The pathophysiological mechanism of arteriosclerosis is the same as osteoporosis. The study analyzed the changes in ankle brachial index and bone mineral density （BMD） in type 2 diabetes patients with coronary atherosclerotic heart disease （CAHD）. METHODS： 503 patients with type 2 diabetes at the Second Artillery Forces General Hospital from April 2004 to April 2007 were enrolled, including 272 males and 231 females. Diabetes diagnosis had complied with the American Diabetes Association （ADA） （1997）. The patients ranged from 25 to 86 years in age （mean 63± 13） years, course of 1 600 months. Patients lying in bed or ankle-brachial index of over 1.4 were excluded. Informed consents were obtained from all patients. All patients were divided into two groups, CAHD and non-CAHD groups. Height, body mass, systemic blood pressure （SBP）, body mass index （BMI） and ocular fundus as well as glycosylated hemoglobin, total cholesterol, triglyceride, high-density lipoprotein cholesterol （HDL-C）, low-density lipoprotein cholesterol （LDL-C）, blood urea nitrogen （BUN）, creatinine, uric acid, urinary microalbuminuria protein levels were measured in the morning at day 1 after admission. Routine 12 lead electrocardiogram （ECG） was performed. The ankle brachial index, lumbar spine （L24）, the left femoral neck, the greater trochanter, bone mineral density （BMD） of fahrenheit triangle were determined by ES-1000SPM Doppler detector and the dual-energy X-ray densitometer （NORLAND, USA）. RESULTS： 503 cases of type 2 diabetes were included in the final results. There were 231 cases in the CAHD group, including 106 male cases, 125 female cases, and 272 cases in the non-CAHD group, including 144 male cases, 128 female cases. Patients in the CAHD group were older, with long diabetes duration, high BMI and low ankle brachial index, and there were significant differences between both groups （P 〈 0.05）. After correction in age, diabetes duration and BMI, BMD of femoral ne

关 键 词：骨密度 冠心病 踝肱指数 2型糖尿病 组织构建 

分 类 号：R681.4[医药卫生—骨科学]