2型糖尿病下肢动脉病变程度与其危险因素的相关性研究  

Correlation Between Lower Extremity Artery Disease and Its Risk Factors in Patients with Type 2 Diabetes Mellitus

作　　者：李艳宁[1] 李芬[1] 李智贤[1] 陈圆圆[1] 廖新红[1] 施丹伟[1] 

机构地区：[1]广西医科大学第一附属医院超声科,南宁市530021

出　　处：《广西医学》2013年第4期385-388,共4页Guangxi Medical Journal

基　　金：国家科技支撑计划课题(2007BAI07A17-11)

摘　　要：目的探讨2型糖尿病(T2DM)下肢动脉病变程度及其危险因素。方法 (1)应用二维超声方法检测60例健康对照组胫前动脉、胫后动脉、足背动脉的中内膜厚度(IMT)及管腔内径,确定中内膜厚度的正常参考范围;(2)超声检查107例T2DM患者下肢动脉病变情况,据病变程度分为5型,对其危险因素进行相关性分析。结果胫前、胫后及足背动脉的IMT正常参考范围≤0.6 mm;107例T2DM患者下肢动脉病变程度为0型19例(17.8%),Ⅰ型21例(19.6%),Ⅱa型23例(21.5%),Ⅱb型25例(23.4%),Ⅲ型19例(17.8%);下肢动脉病变程度与餐后2 h血糖、总胆固醇、非高密度脂蛋白及病程呈正相关(P<0.05)。伴高血压组、周围神经病变组、病程>5年组与无高血压组、无周围神经病变组、病程≤5年组下肢动脉病变程度比较,差异有统计学意义(P<0.05)。结论 IMT>0.6 mm作为提示末梢动脉IMT增厚的标准,有利于T2DM患者下肢动脉早期病变的判断。T2DM患者下肢动脉病变程度与餐后2 h血糖、总胆固醇、非高密度脂蛋白水平、病程、伴发高血压、周围神经病变等因素相关。Objective To explore the correlation between lower extremity artery disease and its risk factors in patients with type 2 diabetes mellitus（T2DM）.Methods ①The intima-media thickness（IMT） and lumen diameters of the anterior tibial artery（ATA）,posterior tibial artery（PTA） and dorsalis pedis artery（DPA） of 60 healthy people were examined by two-dimensional ultrasonography （2DUS） to determine the reference range of IMT.②One hundred and seven T2DM patients were examined for lower extremity artery disease by ultrasonography ,and the disease was divided into 5 types.An analysis of the correlation between pathological changes and the risk factors was performed . Results The IMT of healthy peoples′ATA,PTA and DPA were less than or equal to 0.6 mm.In 107 T2DM patients, there were 19 cases（17.8%） of type 0 lower extremity artery disease ,21（19.6%） cases of typeⅠ,23 cases（21.5%） of typeⅡa,25 cases（23.4%） of typeⅡb,and 19 cases（17.8%） of typeⅢ;There was a positive correlation between the degree of lower extremity artery disease and the factors including 2-hour postprandial blood glucose （PBG2h）, TC, non-HDL-C and course of the disease（P〈0.05）.There was significant difference in the degree of lower extremities artery disease of T2DM patients between patients with hypertension（HT）,peripheral neuropathy（PN）,or the course≤5 years and patients without HT,PN,or the course〉5 years（P〈0.05）.Conclusion It is more conductive to diagnose with the standard as IMT is more than 0.6mm for the lower extremities artery disease on the early stage in T2DM patients.The degree of lower extremity artery disease correlates with the factors including PBG 2h,TC,non-HDL-C,HT and course of the disease.

关 键 词：2型糖尿病 下肢动脉病变 二维超声 危险因素 

分 类 号：R587.1[医药卫生—内分泌] R445.1[医药卫生—内科学]