2型糖尿病患者踝臂指数与颈动脉内中膜厚度的相关性研究  

Correlation between Ankle-Brachial Index and Carotid Intimal Medial Thickness in Type 2 Diabetes

作　　者：王庆开[1] 张丽敏[2] 翁雪燕[3] 陈菊[4] 陈绵雄[3] 郑地明[3] 蒙绪标[3] 邓洪[5] 陈列[6] 

机构地区：[1]海南省海口市人民医院龙昆南门诊部,570208 [2]海南省干部疗养院 [3]海口市人民医院内分泌科 [4]海口市人民医院肾内科 [5]海口市人民医院眼科 [6]海口市人民医院超声影像科

出　　处：《中国全科医学》2011年第28期3228-3231,共4页Chinese General Practice

基　　金：海南省自然科学基金(807092)

摘　　要：目的探讨2型糖尿病(T2DM)患者踝臂指数(ABI)与颈动脉内中膜厚度(CIMT)的相关性及其影响因素。方法对我院住院或门诊就诊的350例不同病程的T2DM患者,检查其ABI、CIMT,血压、身高、体质量、腰围、臀围,空腹血糖(FPG)及餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、血脂、空腹胰岛素(FINS)及餐后2 h胰岛素(2 hINS)、尿清蛋白水平及眼底情况,计算体质指数(BMI)和腰臀比(WHR);并根据ABI将患者分为3组和7组,探讨T2DM患者ABI与CIMT的相关性及其影响因素。结果 T2DM患者ABI和CIMT呈负相关(r=-0.264,P<0.01)。以ABI为应变量,低密度脂蛋白胆固醇(LDL-C)、24 h尿清蛋白、FPG进入回归模型(P<0.05)。结论 T2DM患者ABI和CIMT有相关性,可作为了解动脉粥样硬化的初步筛查指标,ABI<1.11时动脉粥样硬化的检出率明显增高,ABI作为T2DM患者动脉粥样硬化的初步筛查指标时其切入值或应提高;尿清蛋白、LDL-C、FPG是T2DM患者ABI的独立影响因素。Objective To explore the correlation between ankle-brachial index（ABI）and carotid intimal medial thickness（CIMT） and the influence factors among type 2 diabetes mellitus（T2DM） patients. Methods A total of 350 T2DM patients with different disease courses treated by our hospital were included in this study with their ABI,CIMT,blood pressure,height,weight,waist circumference,hip circumference,fasting plasma glucose（FPG） and postprandial 2 h blood glucose（2 hPG）,glycosylated hemoglobin（HbA1c）,blood lipids,fasting insulin（FINS）,postprandial 2 h insulin（2 hINS）,urinary albumin,and fundus state checked.Body mass index（BMI） and waist to hip ratio（WHR） were then calculated.All the cases were divided into 3 groups and 7 groups respectively by different ABI-grouping criteria.Relationship between ABI and CIMT and the influence factors were discussed. Results ABI was negatively correlated with CIMT in T2DM patients（r=-0.264,P0.01）;with ABI as dependent variable,low density lipoprotein cholesterol（LDL-C）,24h urinary albumin,FPG entered the regression model（P0.05）. Conclusion ABI is correlated with CIMT in T2DM and can be used as a preliminary screening indicator for detection of atherosclerosis.The detection rate is significantly higher when ABI1.11.The cut-off value of ABI should be elevated in favor of this aim.Urinary albumin,LDL-C,FPG are among the independent influence factors of ABI in T2DM.

关 键 词：糖尿病 2型 踝臂指数 颈动脉内中膜厚度 

分 类 号：R587.1[医药卫生—内分泌]