ABI评估T2DM并发下肢动脉病变及预测心脑血管病变风险  

Assessment of peripheral arterial disease in patients with type-2 diabetes mellitus and risk prediction of cardio-cerebral vascular diseases by ankle-brachial index

作　　者：陆玮新[1] 罗云[1] 冯波[1] 陈英华[1] 

机构地区：[1]同济大学附属东方医院内分泌科,上海200120

出　　处：《同济大学学报（医学版）》2010年第2期55-57,共3页Journal of Tongji University(Medical Science)

摘　　要：目的探讨和分析踝臂指数(ankle-brachial index,ABI)评估2型糖尿病(type 2 diabetes mellitus,T2DM)并发下肢动脉病变及预测心脑血管疾病的发生风险。方法 157例T2DM患者根据ABI分为下肢动脉病变组(PAD组)和非PAD组,比较两组之间颈动脉内中膜厚度(intima-media thickness,IMT)、脉搏波传导速度(pulsewave velocity,PWV)及各种危险因素的差异。结果 T2DM患者PAD的患病率为13.4%,PAD组冠心病、脑梗死发病风险分别增高6.40、3.67倍,且IMT值、PWV值、HbAlc和TC水平明显升高,HDL-C水平明显下降。相关分析显示ABI与HbAlc、TC、PWV和IMT呈显著负相关。多因素Logistic回归分析提示年龄、LDL-C、HDL-C是ABI的独立危险因素。结论 ABI可评估外周血管病变的严重程度并可有效的预测心脑血管疾病的发病风险。Objective To investigate and analyze whether the ankle-brachial index（ABI） can assess peripheral arterial disease （PAD） in patients with type 2 diabetes mellitus （T2DM） and predict the risk of cardio-cerebral vascular diseases. Methods One hundred and fifty-seven patients with T2DM with or without PAD diagnosed by ABI were included. Carotid artery intima-media thickness （IMT）, pulse wave velocity （PWV）, and various risk factors were compared between groups. Results The prevalence of PAD in patients with T2DM was 13.4%. Compared with patients without PAD, the risk of coronary heart disease and cerebral infarction increased 6.40 and 3.67 times,respectively. The levels of IMT, PWV, HbAlc and total cholesterol （TC） increased significantly, whereas, HDL-C was significantly decreased in patients with PAD. Correlation analysis showed there was a negative correlation between ABI and the levels of HbAlc,TC,PWV,and IMT. Multivariate logistic regression analysis indicated that age,LDL-C and HDL-C were independent risk factors for ABI. Conclusion ABI can assess the severity of peripheral arterial disease and effectively predict the risk of cardio-cerebral vascular diseases.

关 键 词：2型糖尿病 周围血管病变 踝臂指数 颈动脉内中膜厚度 

分 类 号：R587.2[医药卫生—内分泌]