2型糖尿病住院患者踝肱指数异常情况及其影响因素分析  

The Abnormality of Ankle-brachial Index and Its Influencing Factors in Patients with Type 2 Diabetes Mellitus

作　　者：彭金兰[1] 邓春地[1] 丁伊玲 彭仙珍[1] 邓红艳[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院内分泌科,湖北省武汉市430034 [2]伊利诺伊大学香槟分校文理学院,美国伊利诺伊州

出　　处：《中国全科医学》2014年第9期996-1000,共5页Chinese General Practice

摘　　要：目的探讨2型糖尿病住院患者踝肱指数(ABI)异常情况及其影响因素分析。方法选择2011年7月—2012年3月在华中科技大学同济医学院附属普爱医院内分泌科住院的2型糖尿病患者176例,采用超声多普勒血流探测仪测定ABI并分为3组,正常ABI组(0.9≤ABI<1.3)141例、低ABI组(ABI<0.9)24例和高ABI组(ABI≥1.3)11例,收集患者相关病史资料,并检测血脂及糖化血红蛋白(HbA1c)水平,记录并发症发生情况,采用单因素和多因素Logistic回归分析影响ABI的相关因素。结果 176例患者中ABI异常35例,异常率为19.89%,其中ABI<0.9 24例(13.64%)、ABI≥1.3 11例(6.25%)。3组患者的年龄、病程、吸烟率、高血脂患病率及三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、HbA1c水平及冠心病、脑梗死、颈动脉硬化、下肢动脉硬化、糖尿病肾病、视网膜病变、周围神经病变发生率比较,差异均有统计学意义(P<0.05)。单因素Logistic回归分析结果显示,年龄、病程、吸烟史、HbA1c、脑梗死、下肢动脉硬化、大血管病变、糖尿病肾病、周围神经病变与ABI降低有关(P<0.05);性别与ABI升高有关(P<0.05)。多因素Logisitc回归分析结果显示,与正常ABI组相比,年龄、病程、HbA1c、脑梗死、下肢动脉硬化、大血管病变、周围神经病变与ABI降低有回归关系(P<0.05);性别、病程与ABI升高有回归关系(P<0.05)。与高ABI组相比,性别、年龄与ABI降低有回归关系(P<0.05)。结论 2型糖尿病住院患者有较高的ABI异常率,低ABI糖尿病患者慢性并发症发生率较高。ABI检测是筛查和诊断外周动脉疾病的有效办法,具有预测心脑血管病变的重要价值。糖尿病患者应控制吸烟,加强血脂和血糖的监控,特别是高龄、长病程和高HbA1c水平患者。Objective To explore the abnormality of ankle-brachial index （ABI） and its influencing factors in patients with type 2 diabetes mellitus （T2DM）.Methods 176 T2DM patients admitted to the Department of Endocrinology of Pu′ai Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from July 2011 to March 2012 were selected.ABI was detected by ultrasonic Doppler blood flow detector and the patients were divided into three groups：normal ABI group （141 cases,0.9≤ABI〈1.3）,low ABI group （24 cases,ABI〈0.9） and high ABI group （11 cases,ABI≥1.3）.Patients′ history was collected,blood lipid and HbA1c were detected,and the complications were also recorded.Single factor and multi-factor Logistic regression analysis were performed to analyze the influencing factors of ABI. Results 35 out of the 176 patients had abnormal ABI,accounting for 19.89%,including 24 cases of ABI〈0.9 （13.64%） and 11 cases of ABI≥1.3 （6.25%）.The age,course of disease,smoking rate,morbidity of hyperlipidemia,TG,TC,LDL,HDL,HbA1c,incidences of coronary heart disease,cerebral infarction,carotid atherosclerosis,arteriosclerosis in lower extremity,diabetic nephropathy,retinopathy and peripheral neuropathy all showed statistically significant differences among the three groups （P〈0.05）.Single factor Logistic regression analysis showed that age,course of disease,smoking history,HbA1c,cerebral infarction,arteriosclerosis in lower extremity,macroangiopathy,diabetic nephropathy and peripheral neuropathy were related to decreased ABI （P〈0.05）,but gender was related to increased ABI （P〈0.05）.Multi-factor Logistic regression analysis showed that compared with normal ABI group,age,course of disease,HbA1c,cerebral infarction,arteriosclerosis in lower extremity,macroangiopathy and peripheral neuropathy had regression relationship with decreased ABI （P〈0.05）,while gender and course of disease had regression analysis with increased ABI （P〈0.05）.Compared with high

关 键 词：糖尿病 2型 踝肱指数 危险因素 LOGISTIC模型 

分 类 号：R587.1[医药卫生—内分泌]