2型糖尿病并发周围血管病变的临床流行病学分析  

Clinical epidemiological analysis of type 2 diabetes patients with peripheral vascular disease

作　　者：杨维娜[1,2] 王璇[1] 蓝茜[1] 李玥[1] 任娟[1] 何岚[3] 吕社民[1] 李冬民[1] 

机构地区：[1]西安交通大学医学院遗传学与分子生物学系,陕西西安710061 [2]西安市儿童医院检验科,陕西西安710003 [3]西安交通大学医学院第一附属医院风湿免疫科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2013年第1期73-76,共4页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金资助项目(No.30400249);陕西省自然科学基金资助项目(No.2010K16-04);2009年西安交通大学校基金(No.xjj2009079);2010年中央高校基本科研业务费专项基金(No.xjj20100031)~~

摘　　要：目的通过对比分析2型糖尿病并发周围血管病变(DPVD)及未发生周围血管病变(非DPVD)病例的临床流行病学资料,明确2型糖尿患者伴发DPVD的相关危险因素,为其早期诊治和预防提供依据。方法收集157例40～70岁临床已诊断2型糖尿病患者的临床流行病学资料,依据周围血管病的诊断标准将其分为DPVD组和非DPVD组;以生化分析仪测定两组患者的血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和超敏C反应蛋白(hsCRP);用多因素Logistic回归分析相关危险因素。结果与未发生周围血管病变病例相比,DPVD组患者病程较长,且高血压、周围神经病变及糖尿病眼病的并发率较高,生化分析显示DPVD组患者血清中hsCRP、TC/HDL-C水平升高,而HDL-C降低;经多因素Logistic回归分析发现,病程、hsCRP、HDL-C、TC/HDL-C为DPVD的独立危险因素。结论病程、血压增高、周围神经病、眼病、HDL-C减低及hsCRP增高与2型糖尿病患者并发周围血管病变相关,并且病程、HDL-C、hsCRP、TC/HDL-C是周围血管病变的独立危险因素。Objective To explore risk factors of diabetic peripheral vascular diseases （DPVD） by analyzing the clinical epidemiological data of type 2 diabetes patients with or without DPVD. Methods We collected the clinical epidemiological data of 157 patients （aged 40 to 70 years） with type 2 diabetes. According to the standard of diagnosis of DPVD, the patients were divided into DPVD group （79 cases） and non-DPVD group （78 cases）. Biochemical indicators, including serum total cholesterol （TC）, triglycerides （TG）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C） and high-sensitivity C-reactive protein （hsCRP）, were determined by biochemical methods. Logistic regression analysis was used to find out risk factors of DPVD among these data. Results Compared to the non-DPVD group, DPVD group showed longer duration of the disease and higher incidence of complications with high blood pressure, peripheral neuropathy and diabetic oculopathy. The re- sults of biochemical indicators demonstrated that serum hsCRP, HDL-C and TC/HDL-C in DPVD patients differed significantly from those of non-DPVD patients. And diabetes duration, hsCRP, HDL-C and TC/HDL-C were the independent risk factors of type 2 diabetes developing peripheral vascular disease. Ooflclusion DPVD patients showed different clinical manifestations and biochemical indicators from those of non-DPVD group. And among them, diabetes duration, hsCRP, HDL-C and TC/HDL-C were the independent risk factors of type 2 diabetes developing peripheral vascular complications.

关 键 词：2型糖尿病 周围血管病变 病程 高密度脂蛋白胆固醇(HDL—C) 超敏C反应蛋白(hsCRP) 危险因素 

分 类 号：R587.1[医药卫生—内分泌]