2型糖尿病患者臂-踝脉搏波传导速度与视网膜病变的关系  

Correlation between brachial-ankle pulse wave velocity and diabetic retinopathy in type 2 diabetes

作　　者：董文丽[1] 邓欣如[1] 徐敏[1] 徐佰慧[1] 田晓光[1] 毕宇芳[1] 陈宇红[1] 王卫庆[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院内分泌代谢病科上海市内分泌代谢病临床医学中心上海市内分泌代谢病研究所,上海200025

出　　处：《内科理论与实践》2013年第6期410-413,共4页Journal of Internal Medicine Concepts & Practice

基　　金：国家自然科学基金(项目编号:81170739);上海市自然科学基金(项目编号:102R1426400)

摘　　要：目的：研究2型糖尿病患者臂一踝脉搏波传导速度（ba—PW）与糖尿病视网膜病变患病风险的相关性。方法：收集我院内分泌代谢病科门诊的2型糖尿病患者1000例，对其进行问卷调查、体格检查、生化检测、ba-PwV检测、眼底检查．并将ba-Pwv按照三分位分组．分析ba-Pwv水平与糖尿病视网膜病变的相关性。结果：①根据ba-PWV水平按照三分位分组，每组的糖尿病视网膜病变患病率分别为5．6％（18／3191、11．0％（35／319）、14．2％（45／319），组间趋势明显（趋势P=0．0004）。②多元Logiistic回归分析显示，糖尿病视网膜病变与糖化血红蛋白（HbA．。）、糖尿病病程、使用降糖药物治疗呈显著正相关，比值比fOR）分别为1．35、1．07和2．59（均P〈0．001）：与年龄呈显著负相关（OR=0．96，β=-0．04l，P=-0．01）。③校正多种影响因素后，多元Logistic回归分析显示，与下三分位组相比，ba—Pwv位于第2、第3三分位组的糖尿病视网膜病变患病风险显著增高．OR[95％N信区IN（CI）]分别为2．34（1．20～4．57）、2．89（1．33，6．191，趋势P=-0．0091。结论：在2型糖尿病人群中．ba—PWV异常是糖尿病视网膜病变的独立危险因素，且与糖尿病视网膜病变的患病风险密切相关。因此．对ba-PwV的测量可用于评估糖尿病视网膜病变的患病风险。Objective To study the correlation between brachial-ankle pulse wave velocity （ba-PWV） and diabetic retinopathy in type 2 diabetic patients. Methods This cross-sectional investigational study included 1 000 type 2 diabetic patients who had received non-mydriatic digital fundus photography examination, questionnaire survey, physical examination, blood and urine biochemical tests, and ba-PWV measurement. And the correlation between ba-PWV and diabetic retinopathy was analyzed. Results Subjects were divided into three groups according to ba-PWV tertiles. Compared with patients in the lowest tertile, those in the second and highest tertiles had significantly higher prevalence of diabetic retinopathy （5.6%, 11.0%, and 14.2%, respectively, P for trend=0.000 4）. Multiple Logistic analysis revealed that hemoglobin AIc （HbAIc）, duration of diabetes and use of hypoglycemic drug therapy were positively correlated with prevalence of diabetic retinopathy [odds ratio （0R）=1.35, 1.07 and 2.59, all P〈0.001], while age was inversely correlated with prevalence of diabetic retinopathy （OR=0.96, β=-0.041 ,P=-0.01）. Adjusted Logistic regression analysis revealed that compared with patients in the lowest tertile of ba-PWV, those in the second and highest tertiles had 2.34-fold and 2.89- fold increase of prevalence of diabetic retinopathy, respectively. Conclusions In type 2 diabetic patients, ba-PWV is an independent risk factor of diabetic retinopathy, and has significant correlation with diabetic retinopathy. Therefore, ba- PWV might be a useful marker for evaluating the risk of diabetic retinopathy.

关 键 词：臂-踝脉搏波传导速度 2型糖尿病 糖尿病视网膜病变 

分 类 号：R587.1[医药卫生—内分泌]