踝肱指数(ABI)对糖尿病下肢动脉病变的筛查及其临床应用  

Value of ankle brachial index in screening of diabetes lower limb artery disease and its clinical application

作　　者：潘佳秋[1] 张超[1] 田建武[1] 

机构地区：[1]佳木斯大学附属第一医院内分泌科,黑龙江佳木斯154003

出　　处：《黑龙江医药科学》2009年第6期3-4,共2页Heilongjiang Medicine and Pharmacy

摘　　要：目的:探讨踝肱指数(ABI)对糖尿病下肢动脉病变的筛查的意义及其临床应用。方法:取ABI阳性者68例入院治疗患者,随机分为A、B两组,A组为单纯降糖、降血脂治疗,B组除降糖、降血脂外加用丁咯地尔治疗,治疗3个月后再次复查ABI,观察两组治疗前后ABI、血压、空腹血糖(FPG)、餐后2h血糖(2hPG)、总胆固醇(TC)、甘油三脂(TG)变化。结果:1538例糖尿病患者ABI测定阳性者为394例,阳性率为25.6%,ABI阳性患者经下肢动脉彩超证实符合率达100%,ABI阳性者距诊断糖尿病病史1月至20年,ABI阳性患者病史超过5年者阳性率高达80%。治疗前患者年龄、病程、BMI、SBP、FPG、2hPG、TG、TC、ABI差异均无统计学意义,经治疗后A组患者FPG、TG明显下降(P<0.05),SBP、ABI无明显变化。B组患者治疗后较治疗前FPG、TG明显下降(P<0.05),SBP无明显变化,ABI明显改善(P<0.05)。结论:ABI与下肢血管彩超对比相关性好,踝肱指数测量仪既可在诊室中使用,也适用于大规模人群的筛查;应用盐酸丁咯地尔后,临床症状及相关指标均显著优于对照组,ABI明显升高。Objective：To explore the significance and the value of clinical application of ankle brachial index （ABI） in diabetes patients in screening the lower limb artery disease. Methods：We selected 68 hospitalized diabetes patients with positive ABI and randomly divided them into two groups, Group A and Group B. Both groups were given hypoglycemic, lipid-lowering therapy, and Buflomedil was added to Group B. After 3- month treatment, the ABI was re-examined and the changes of blood pressure, fasting plasma glucose（FPG）, postprandial 2 h plasma glucose （2hPG）,cholesterol total（TC） and triglyceride（TG） were observed. Results： There were 394 diabetes patients whose ABI was positive in 1538 cases , the positive rate being 25. 6% ,and the ABI positive patients showed the coincident rate of 100%, confirmed by the lower extremity arterial color Doppler. The history of diagnosed diabetes ranged from 1 month to 20 years in the ABI positive patients. The ABI positive patients with a 5-year diabetes history accounted for 80%. There was no significance in the patient age, course.of disease, BMI, SBP,FPG, 2hPG,TG,TC and the ABI before the treatment. After treatment, the FPG and TG of Group A were significantly decreased （P 〈 0. 05） , with no obvious changes in the SBP and ABI. The FPG and TG of Group B were significantly decreased too （P （0.05） ,with no obvious changes in the SBP, and the ABI showed an obvious improvement （P 〈 0. 05） . Conclusion：There is a good correlation between the ABI and the lower limb Color Doppcr flow imaging, and the measuring instrument of ankle brachial index can be used not only in the consulting room but also in the large-scale screening. After treatment with Buflomedil, there is more improvement in the clinical symptoms and the related indexes in the Group B with an obvious increase in the AEI compared with Group A.

关 键 词：2型糖尿病 踝肱指数 下肢动脉病变 丁咯地尔 

分 类 号：R587.1[医药卫生—内分泌]