糖尿病患者踝臂指数与全因和心血管病死亡率关系的研究  

Prospective investigation on association of ankle brachial arterial index with all-cause and cardiovascular disease mortality in patients with diabetes

作　　者：钟树妹[1] 张四青[1] 曾宪忠[1] 刘泽洪[1] 郭经琴[1] 

机构地区：[1]江西省赣州市人民医院内分泌科,赣州341000

出　　处：《江西医药》2011年第12期1063-1065,共3页Jiangxi Medical Journal

摘　　要：目的研究糖尿病患者外周动脉疾病(peripheral arterial disease,PAD)踝臂指数(ankle-brachial index,ABI)与全因和心血管病(cardiovascular disease,CVD)死亡率的关系。方法研究对象来自2006年6月至2009年6月我医院的有完整ABI基线资料的糖尿病患者528例,于2006年12月至2009年12月对其进行随访调查。结果 528例糖尿病患者中,ABI降低的PAD组178例(33.71%),ABI正常的非PAD组350例(66.29%),血压和吸烟史是PAD的独立危险因素,在34.8个月的随访中,有33例死亡,其中17例为CVD死亡。经COX回归分析,PAD患者发生全因及CVD死亡的相对危险度分别为1.513(0.892-2.964)和4.526(0.981-13.520)。随着ABI水平降低,发生死亡及CVD死亡危险增加。结论低ABI是糖尿病患者死亡和CVD死亡的独立危险因素,在糖尿病人群中运用无创性ABI测定对全因死亡及CVD死亡具有预测价值。Objective To evaluate the risk factors for peripheral arterial disease（PAD）and association of the ankle brachial index（ABI）with cardiovascular disease（CVD）mortality in patients with diabetes.Methods The ABI cohort study was initiated from June 2006 to investigate factors of PAD and the relationship between ABI and all-cause and CVD monality in 528 diabetic patients of Ganzhou areas.ABl was ascertained at baseline by measuring systolic blood pressures on bilateral brachial and tibial arteries.Mortality surveillance was completed from December 2006 to December 2009.Results Among 528 participants with diabetes at baseline,178（33.71%）were in low ABI group and 350（66.29%）were in normal group.Blood pressure and smoking were associated low ABI in patients with diabetes.During 34.8-month follow-up,there were 33 deaths,of which 17 were attributable to CVD.Low ABI was associated with adjusted a11-cause and CVD mortality risk of 1.513（0.892～2.964） and 4.526（0.981～13.520）respectively in Cox regression models.The rate of survival in low ABI was significantly lower than that in normal ABI group.The risk of all-cause and CVD mortality increased with the lowered ABI.Conclusion Low ABI was independently associated with the high risks of a11-cause and CVD mortalities in patients with diabetes.The utility of non-invasive ABI as a tool for predicting mortality for diabetic patients should be popularized.

关 键 词：糖尿病 死亡率 踝臂指数 外周动脉疾病 

分 类 号：R587.1[医药卫生—内分泌]