2型糖尿病下肢血管病变发生率及相关因素调查  

The prevalence of vascular lesions in the lower extremities and their risk factors in type 2 diabetic mellitus

作　　者：潘长玉[1] 高妍[2] 袁申元[3] 李光伟[4] 王姮[5] 陆菊明[1] 李俊来[1] 杨国庆[1] 张俊清[2] 陈铭[2] 朱良湘[3] 刘效慈[3] 肖平 张学文[4] 肖新华[5] 李文慧[5] 姜育新[5] 

机构地区：[1]解放军总医院内分泌科,邮政编码100853 [2]北京大学第一医院 [3]北京同仁医院 [4]卫生部中日友好医院 [5]中国医学科学院中国协和医科大学北京协和医院

出　　处：《中国糖尿病杂志》2001年第6期323-326,共4页Chinese Journal of Diabetes

基　　金：天津大塚制药公司资助

摘　　要：目的　调查 2型糖尿病患者下肢血管病变发生率及其相关因素。方法　于北京地区 5所医院对随机选择所在医院随诊 1年以上 ,发病年龄≥ 40岁 ,病程≥ 5年的 2型糖尿病患者 393例 ,进行病史回顾 ,体格检查 ,生化检查和下肢血管多普勒超声检查。结果　 393例患者中下肢坏疽 8例 (2 .0 % ) ,间歇性跛行 2 8例 (7.1% )。超声多普勒检查提示有不同程度下肢血管病变者 35 7例 (90 .8% ) ,其中以 6 8例 (17.8% )踝 /肱动脉压比值 <1.0者与以下临床情况相关明显 :糖尿病肾病和视网膜病变发生率高 (P<0 .0 5 ) ,FBS和 Hb Alc水平高 (P<0 .0 5 ) ,HDL - ch水平低 (P<0 .0 5 ) ,舒张压高(P<0 .0 1)。且踝 /肱比值与 FBS、Hb Alc、Tg、纤维蛋白原、血压呈负相关 ,与 HDL- ch呈正相关 (P<0 .0 5 )。结论　 2型糖尿病患者下肢血管病变常见 ,与血糖、血脂、血压以及血凝多种因素有关。超声多普勒检查能较早地发现病变 ,而踝 /肱比值是下肢血管病变的一种方便可行和可靠的检测指标。Objective To investigate the prevalence of vascular disease in the lower extremities and its related risk factors in type 2 diabetic patients.Methods A total of 393 type 2 diabetic patients treated in 5 hospitals in Beijing were randomly recruited for the study with their age of more than 40 years at onset,diabetes duration of more than 5 years and treatment for more than 1 year in each hospital.The case history,physical examination,biochemical tests and ultrasonic Doppler examination were conducted in these patients.Results Eight patients had gangrene (2.0%) and 28(7.1%) had intermittent claudication in 393 diabetics,while ultrasonic examination showed that 357 cases (90.8%) had vascular lesions in the lower limbs.Ankle/brachial systolic pressure ratio (API,Ankle pressure index) less than 1.0 was found in 68 cases (17.8%).The higher prevalence of diabetic nephropathy and retinopathy,higher fasting blood sugar and HbAlc,higher diastolic pressure and lower HDL ch levels ( P <0.05) were significantly correlated with API less than 1.0.Their API was in negative relationship with the fasting blood sugar,HbAlc,triglyceride,fibrinogen levels and blood pressure,and in positive relationship with HDL ch levels ( P <0.05).Conclusion Vascular lesions in lower limbs were common in type 2 diabetes mellitus.These lesions could be found earlier with the ultrasonic Doppler examination.

关 键 词：2型糖尿病 大血管病变 超声波检查 

分 类 号：R587.2[医药卫生—内分泌] R543[医药卫生—内科学]