2型糖尿病患者踝臂指数、趾臂指数的变化及其与糖尿病足的相关性  

Change of ankle brachial index and toe brachial index in type 2 diabetes mellitus and the correlation with diabetic foot

作　　者：丁亚琴[1] 吴坚[1] 邵筱宏 竺春玲 谢心[1] 刘继博[1] 沈晓喻 陆侃[1] 

机构地区：[1]上海市中西医结合医院内分泌科,200082

出　　处：《疑难病杂志》2015年第11期1133-1136,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨2型糖尿病(DM)患者踝臂指数(ABI)、趾臂指数(TBI)的变化,及其与糖尿病足(DF)的相关性。方法回顾性分析2013年1月—2014年12月收治的126例2型DM患者的临 床资料,其中并发DF 95例(DF组),未并发DF 31例(NDF组)。检测2组患者ABI、TBI水平的变化,采用多因素Logistic回归对DF的危险因素进行分析。结果 DF组与NDF组患者在2型DM病程、BMI、FPG、HbA_(1c)、TC、TG、HDL-C、ABI、TBI等9个因素差异均有统计学意义(P<0.05);不同Wagner分级的DM患者ABI、TBI比较,差异均有统计学意义(P<0.05),且随着Wagner分级的增加,ABI、TBI的异常率明显升高,数值明显降低(P<0.05)。Spearman秩相关性分析,ABI、TBI与Wagner分级均呈明显负相关(r=-0.593、-0.604,P<0.05);ABI、TBI联合检测,对DF的诊断敏感度(93.7%),明显高于ABI(69.5%)、TBI(67.4%)单独检测(P<0.05);多因素非条件Logistic回归分析,HDL-C、ABI、TBI均是DF的保护因素(P<0.05),病程、HbA_(1c)为危险因素(P<0.05)。结论 2型DM患者ABI、TBI明显降低,且与DF的发生及严重程度密切相关,ABI、TBI联合检测有助于提高DF的诊断敏感度。Objective To investigate the changes of ankle brachial index（ABI） and toe brachial index（TBI） in palients with type 2 diabetes mellitus（DM） and the correlation with diabolic foot（DF）.Methods Retrospectively analyzed from January 2013 to December 2014 clinical data of 126 patienis with type 2 DM,95 cases among them（group DF） were complicated with DF,and 31 cases（group NDF） were not complicated with DF.ABI and TBI levels were detected in（he 2groups,and the risk factors of DF were analyzed by Logistic regression.Results Group DF and group NDF＇s type 2 DM,BM1,FPG and HbA_（1c）,TC,TG.HDL-C,ABI and TBI showed statistically significant differences（P〈0.05）;different Wagner classification of DM patients＇ ABI and TBI showed statistically significant differences（P〈0.05）,and along with the increase of Wagner classification,the abnormal rale of ABI and TBI were increased significantly,the number were significantly decreased（P〈0.05）.Spearman rank correlation analysis showed that,ABI and TBI and Wagner classification had significant negative correlation（r =-0.593,r =-0.604,P〈0.05）;ABI and TBI combined for detection,the sensitivity for diagnosis of DF（93.7%） was significantly higher than that of ABI（69.5%） and TBI（67.4%） along（P〈0.05）;multi-factor non-conditional Logistic regression analysis showed that,HDL-C,ABI and TBI are DF protective factors（P〈0.05）,duration of diabetes,HbA_（1c） were the risk factors（P〈0.05）.Conclusion It demonstrated that the TBI,ABI were significantly decreased in type 2 DM patients,and were closely related with the occurrence and severity of DF,the combination ABI and TBI detection was helpful lo Improve the diagnostic sensitivity of DF.

关 键 词：2型糖尿病 糖尿病足 踝臂指数 趾臂指数 

分 类 号：R587.2[医药卫生—内分泌]