甲状腺过氧化物酶抗体与2型糖尿病下肢血管病变的相关性研究  

Study on the correlation between thyroid peroxidase antibody and vascular disease of lower extremities in patients with type 2 diabetes mellitus

作　　者：杨洁[1] 丁文萃[1] 王海英[1] 史亚男 YANG Jie;DING Wen-cui;WANG Hai-ying;SHI Ya-nan(The First Department of Diabetes and Endocrine Medicine,Cangzhou Central Hospital,Hebei Province,Cangzhou 061000,China)

机构地区：[1]河北省沧州市中心医院内分泌糖尿病一科,河北沧州061000

出　　处：《河北医科大学学报》2023年第2期152-156,共5页Journal of Hebei Medical University

基　　金：沧州市重点研发计划指导项目(204106137)。

摘　　要：目的探讨甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPO-Ab)对2型糖尿病(diabetes mellitus type 2,T2DM)下肢血管病变的影响。方法回顾性收集沧州市中心医院收治的T2DM患者500例的临床资料,根据患者TPO-Ab水平分为阳性组(n=73,TPO-Ab≥34 U/ml)和阴性组(n=427,TPO-Ab<34 U/mL),记录两组患者下肢血管病变的发生情况,并根据T2DM患者是否发生下肢血管病变分为发生组(n=186)和未发生组(n=314),分析TPO-Ab与T2DM下肢血管病变的相关性。结果TPO-Ab阳性组下肢血管病变发生率为56.16%(41/73),阴性组发生率为33.96%(145/427),阳性组下肢血管病变发生率高于阴性组(χ2=13.160,P<0.01)。经单因素分析后进一步行Logistic回归分析显示,冠心病(OR=10.345)、脑梗死病史(OR=26.942)、T2DM病程(OR=1.921)、TPO-Ab(OR=2.080)、三酰甘油(OR=1.531)、低密度脂蛋白胆固醇(OR=1.559)、糖化血红蛋白(OR=1.703)、餐后2 h血糖(OR=1.119)是T2DM下肢血管病变的不良影响因素(P<0.01,P<0.05)。结论TPO-Ab≥34 U/mL的T2DM患者下肢血管病变发病率高于TPO-Ab<34 U/mL的T2DM患者,在临床工作中应加强T2DM患者群体TPO-Ab的筛查,并且重视对上述不良影响指标的评估及控制,以利早期预防或延缓T2DM患者下肢血管病变的进程。Objective To investigate the effect of thyroid peroxidase antibody(TPO-Ab)on vascular disease of lower extremities in patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 500 patients with T2DM who were admitted to Cangzhou Central Hospital were retrospectively collected.According to the level of TPO-Ab,the patients were divided into the positive group(TPO-Ab≥34 U/mL,n=73)and negative group(TPO-Ab<34 U/mL,n=427),and the incidence of vascular disease of lower extremities in two groups was recorded.According to presence or absence of vascular disease of lower extremities in patients with T2DM,they were divided into the occurrence group(n=186)and the non-occurrence group(n=314),and the correlation between TPO-Ab and vascular disease of lower extremities in patients with T2DM was analyzed.Results The incidence of vascular disease of lower extremities was 56.16%(41/73)in the positive group,which was higher than that[33.96%(145/427)]in the negative group(χ2=13.160,P<0.01).Univariate analysis was performed,and further Logistic regression analysis showed that coronary heart disease(OR=10.345),history of cerebral infarction(OR=26.942),duration of T2DM(OR=1.921),TPO-Ab(OR=2.080),triglycerides(OR=1.531),low density lipoprotein cholesterol(OR=1.559),glycosylated hemoglobin(OR=1.703),2h postprandial blood glucose(OR=1.519)were the influencing factors of vascular disease of lower extremities in patients with T2DM.Conclusion The incidence of vascular disease of lower extremities in T2DM patients with TPO-Ab≥34 U/mL is higher than that of T2DM patients with TPO-Ab<34 U/mL.Clinicians should strengthen the screening of TPO-Ab,as well as evaluation and control of the above influencing indicators in T2DM patients,so as to prevent or slow down the progression of vascular disease of lower extremities in T2DM patients.

关 键 词：糖尿病 2型 碘化物过氧化物酶 下肢血管病变 

分 类 号：R587.1[医药卫生—内分泌]