2型糖尿病患者踝肱指数异常率及其危险因素  

Prevalence and risk factors of abnormal ankle-brachial index in patients with type 2 diabetes

作　　者：李翔[1] 王玉珍[1] 肖婷[1] 刘彦君[1] 杨小平[1] 许樟荣[1] 

机构地区：[1]解放军306医院全军糖尿病中心,北京100101

出　　处：《中华老年多器官疾病杂志》2011年第4期305-309,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的比较2型糖尿病患者中正常、低和高踝肱指数(ABI)的发生率和相关临床危险因素。方法对2003年9月至2010年6月进行ABI测定的3924名2型糖尿病患者的病史资料及检查结果进行回顾分析。采用单变量和Logistic回归判断异常ABI的危险因素。结果 93.1%(3653例)患者ABI在正常范围,5.2%(206例)患者ABI值<0.9,1.7%(65例)患者ABI值≥1.3。≥65岁患者中ABI值<0.9的比例明显高于<65岁患者(12.2%vs 3.6%,P<0.001)。糖化血红蛋白、尿白蛋白/肌酐、糖尿病周围神经病变、糖尿病视网膜病变以及脑血管疾病是<65岁患者低ABI的独立危险因素。年龄、吸烟、糖化血红蛋白、尿酸、总胆固醇、糖尿病周围神经病变、糖尿病肾病及脑血管疾病是≥65岁患者低ABI的独立危险因素。男性则与<65岁患者高ABI有关。结论 2型糖尿病患者尤其是老年糖尿病患者中异常ABI的比例较高,应早期识别其危险因素并强化干预以改善糖尿病患者的生活质量及其预后。Objective To examine the prevalence of normal, low and high ankle-brachial index（ABI） in patients with type 2 diabetes and the relative risk factors. Methods A total of 3924 patients, who underwent ABI examination in our center between September 2003 and June 2010, were enrolled. Their medical profiles and laboratory data were analyzed retrospectively. The risk factors for abnormal ABI were determined using univariate and stepwise Logistic regression analysis. Results ABI was normal in 3653 patients（93.1%）, 〈 0.9 in 206 patients（5.2%）, and ≥1.3 in 65 patients（1.7%）. Elderly patients （≥65 years） had a higher prevalence of low ABI than non-elderly patients（ 〈 65years）（ （12.2% vs 3.6%）. Using normal ABI as referent, low ABI in non-elderly patients was independently associated with HbAlc, urine albumin to creatinine ratio, diabetic peripheral neuropathy, diabetic retinopathy and cerebral vascular disease. Low ABI in elderly patients was independently associated with age, smoking, HbAlc, uric acid, total cholesterol, diabetic peripheral neuropathy, diabetic retinopathy, diabetic nephropathy and cerebral vascular disease. High ABI in non-elderly patients was associated with male gender. Conclusions The prevalence of abnormal ABI is high in patients with type 2 diabetes, especially in elderly patients. Early identification and intensive treatment are strongly recommended to improve the patients＇ life quality and overall prognosis.

关 键 词：糖尿病 2型 踝肱指数 危险因素 周围动脉疾病 

分 类 号：R587.1[医药卫生—内分泌] R587.2[医药卫生—内科学]