2型糖尿病踝肱指数与周围神经病变的关系：427例临床分析  

Ankle-brachial index and diabetic peripheral neuropathy in patients with type 2 diabetes： clinical analysis of 427 cases

作　　者：李明[1] 赵青松[1] 霍莹莹[1] 李芸兰[1] 夏楠[1] 赵楠[1] 朱建森[1] 成志锋[1] 

机构地区：[1]哈尔滨医科大学附属第四医院内分泌科,哈尔滨150001

出　　处：《中华老年多器官疾病杂志》2012年第7期484-487,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：黑龙江省自然科学基金资助项目（ZD201108）

摘　　要：目的探讨2型糖尿病患者踝肱指数与糖尿病周围神经病变（DPN）之间的关系。方法对427例2型糖尿病患者采用多普勒血流探测仪测定踝肱指数（ABI），并依据ABI分为，周围动脉病变（PAD）组（ABI〈0．9）和非PAD组（ABI≥0．9），同时检测所有患者胫后感觉神经传导速度（NCV）、潜伏期、振幅，进行组间比较，并对上述指标进行线性相关分析及多元线性回归。结果ABI〈0．9者115例，占26．9％，与非PAD组比较，PAD组周围NCV明显下降【左NCV：（30±8）VS（32±7）m／s，右NCV：（29±6）VS（33±7）m／s，P〈0．01]，潜伏期延长[左潜伏期：（8．2±2．0）VS（7．4±1．4）ms，右潜伏期：（8．3±1．7）w（7．4±1．3）ms，P〈0．01]，振幅下降[左振幅：（10±12）vs（15±16）mV，右振幅：（9±7）vs（14±13）mV,P〈0．011；相关分析显示，踝肱指数与潜伏期呈负相关、与振幅呈正相关；在调整年龄、病程、体质量指数（BMI）、收缩压、总胆固醇、低密度脂蛋白胆固醇（LDL．C）、血肌酐、NCV和振幅，多元逐步回归提示，ABI与年龄、LDL．C、NCV、BMI相关。结论2型糖尿病患者中，PAD可能是DPN的重要危险因素或影响因素。Objective To investigate the relationship between ankle-brachial index （ABI） and diabetic peripheral neuropathy （DPN） in patients with type 2 diabetes mellitus（T2DM）. Methods ABI was determined in 427 patients with T2DM by Doppler ultrasound, and the patients were divided into group A （ABI≥0.9） and group B （ABI 〈 0.9）. The sensory nerve conduction velocity （NCV）, latent period and amplitude of posterior tibial nerve in all patients with T2DM were determined by electromyography. These indexes were compared between the two groups, and their relationships were analyzed by linear correlation analysis and multiple linear regression. Results There were 115 patients with ABI 〈 0.9 in group B, accounting for 26.9%. The nerve conduction velocity [left NCV： （30 ±8） vs （32 ± 7） m/s, right NCV： （29 ± 6） vs （33 ± 7） m/s, P 〈 0.01] and amplitude [left amplitude： （10 ± 12） vs （15 ± 16） mV, right amplitude： （9 ± 7） vs （14 ± 13） mV, P 〈 0.01] of posterior tibial nerve were lower in group B than in group A, and the latent period [left latent period： （8.2 ± 2.0） vs （7.4 ± 1.4） ms, right latent period： （8.3 ±1.7） vs （7.4 ± 1.3） ms, P 〈 0.01] of posterior tibial nerve were higher in group B than in group A. ABI was negatively correlated with latent period and positively correlated with amplitude of posterior tibial nerve in T2DM patients. After adjustment with a series of confounding factors such as age, course of disease, body mass index （BMI）, systolic blood pressure, total cholesterol, low density lipoprotein cholesterol （LDL-C）, serum creatinine, NCV and amplitude, multivariate analysis results demonstrated that ABI was associated with age, LDL-C, NCV and BMI. Coneluslons In patients with T2DM, peripheral artery disease is a potentially important influencing factor for diabetic peripheral neuropathy.

关 键 词：糖尿病 2型 踝肱指数 糖尿病并发症 糖尿病周围神经病变 

分 类 号：R587.1[医药卫生—内分泌]