2型糖尿病下肢血管病变的临床流行病学分析  

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

作　　者：高林英[1] 任文霞[2] 冯永亮[3] 

机构地区：[1]山西医科大学公共卫生学院卫生检验教研室,山西太原030001 [2]太原市中心医院内分泌科,山西太原030009 [3]山西医科大学公共卫生学院流行病学教研室,山西太原030001

出　　处：《中华疾病控制杂志》2014年第4期308-311,共4页Chinese Journal of Disease Control & Prevention

摘　　要：目的了解2型糖尿病下肢血管病变的发生情况、临床特征等,并探讨其危险因素。方法收集2型糖尿病患者身高、体重和糖尿病病程等一般临床资料,检测炎症因子、血糖和胆固醇等常规临床生化指标,测定踝肱指数,进行下肢血管彩色多普勒超声检查。结果 1 253名2型糖尿病患者中发生下肢血管病变者564例(45.01%)。下肢血管病变组年龄、糖尿病病程和体质指数高(t=16.13、19.59和7.83,均有P<0.05),超敏C反应蛋白(high sensitive C-reactive proteins,hsCRP)、空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(hemoglobin A1c,HbA1c)、总胆固醇(Total Cholesterol,TC)和甘油三酯(triglyceride,TG)等也高(t=55.80、10.70、14.64、2.47和8.35,均有P<0.05),高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)则低(t=-3.83,P<0.05);Logistic回归分析显示,随着糖尿病病程、hsCRP、TC/HDL-C比值和HbA1c的增加,糖尿病下肢血管病变发生危险增加(均有P<0.05)。结论 2型糖尿病下肢血管病变发生率高,糖尿病病程、hsCRP、TC/HDL-C比值和HbA1c是糖尿病下肢血管病变的危险因素。Objective To study the incidence,clinical features and potential risk factors for type 2 diabetes patients with peripheral artery disease（ PAD）. Methods Interview was conducted to collect informations on the general clinical data such as height,weight and course of disease. Serum levels of high-sensitivity C-reactive protein（ hsCRP）,bloodglucose and cholesterol were detected. Ankle brachial index（ ABI） and color Doppler ultrasonography of peripheral artery were also determined. Results Among the 1 253 study subjects,PAD accounted for 45. 01%. Compared with those without PAD,age,course of disease and body mass index increased（ t = 16. 13,19. 59 and 7. 83,all P 0. 05）,levels of high-sensitivity C-reactive protein（ hsCRP）,fasting blood-glucose（ FBG）,total cholesterol（ TC）,triglyceride（ TG）,and glycosylated hemoglobin（ HbA1c） increased（ t = 55. 80,10. 70,14. 64,2. 47 and 8. 35,all P 0. 05）,level of high-density lipoprotein cholesterol（ HDL-C） decreased（ t =- 3. 83,P 0. 05）. Multivariate Logistic regression analysis showed that course of disease,level of hsCRP and HbA1c,and TC/HDL-C were risk factors（ all P 0. 05）. Conclusions The incidence of peripheral artery disease was high among patients with type 2 diabetes mellitus. Course of disease,level of hsCRP and HbA1c,and TC/HDL-C were risk factors for type 2 diabetes mellitus with PAD.

关 键 词：糖尿病 2型 下肢 糖尿病血管病变 流行病学 

分 类 号：R587.1[医药卫生—内分泌] R181.1[医药卫生—内科学]