初诊糖尿病患者下肢动脉病变的临床特征  

Clinical characteristics of lower extremity arterial disease in newly diagnosed diabetes patients

作　　者：苏颖思 林海真 陈盛宇 徐烨婷 Su Yingsi;Lin Haizhen;Chen Shengyu;Xu Yeting(Department of Endocrinology and Metabolism,Liwan Central Hospital of Guangzhou,Guangzhou 510170,Guangdong,China;Department of Cardiology,Liwan Central Hospital of Guangzhou,Guangzhou 510170,Guangdong,China;Department of General Surgery,Liwan Central Hospital of Guangzhou,Guangzhou 510170,Guangdong,China)

机构地区：[1]广州市荔湾中心医院内分泌代谢病科,广东广州510170 [2]广州市荔湾中心医院心血管科,广东广州510170 [3]广州市荔湾中心医院普外科,广东广州510170

出　　处：《血管与腔内血管外科杂志》2024年第11期1356-1360,共5页Journal of Vascular and Endovascular Surgery

基　　金：广州市荔湾区科技计划项目(20220009)。

摘　　要：目的 探讨初诊糖尿病患者发生下肢动脉病变的临床特征。方法 收集2021年6月至2023年6月广州市荔湾中心医院收治的202例初诊2型糖尿病(T2DM)患者的临床资料,按照下肢动脉病变发生情况将其分为病例组(n=67)和对照组(n=135),分析初诊T2DM患者发生下肢动脉病变的影响因素。结果 病例组患者吸烟、高血压、C反应蛋白(CRP)升高、低密度脂蛋白胆固醇(LDL-C)升高、下肢感觉异常比例均高于对照组患者,差异均有统计学意义(P﹤0.05)。病例组患者踝肱指数(ABI)为0.64~0.89,平均(0.81±0.19),13例ABI﹤0.70,54例ABI为0.70~0.90;单侧下肢病变29例(43.3%),双下肢病变38例(56.7%);狭窄最严重部位:股腘动脉21例,胫腓动脉37例,足背动脉9例。多因素分析结果显示,吸烟、高血压、CRP升高、LDL-C升高以及下肢感觉异常均是初诊T2DM患者发生下肢动脉病变的危险因素(P﹤0.05)。结论 初诊T2DM患者中合并下肢动脉病变的比例较高,吸烟、高血压、CRP升高、LDL-C升高、下肢感觉异常均是初诊T2DM患者发生下肢动脉病变的危险因素,临床可根据上述因素对初诊T2DM患者进行评估和后续的针对性检查。Objective To investigate the clinical features of lower extremity arterial disease in newly diagnosed diabetic patients.Method Clinical data of 202 newly diagnosed type 2 diabetes mellitus(T2DM) patients admitted to Liwan Central Hospital of Guangzhou from June 2021 to June 2023 were collected,they were divided into case group(n=67) and control group(n=135) according to the occurrence of lower extremity artery lesions,the influencing factors of lower extremity artery lesions in newly diagnosed T2DM patients were analyzed.Result The proportions of smoking,hypertension,C-reactive protein(CRP),low-density lipoprotein cholesterol(LDL-C) and paresthesia of lower extremity in case group were higher than those in control group,with statistical significances(P<0.05).The ankle brachial index(ABI) of patients in the case group was 0.64-0.89,with an average of(0.81±0.19),13 cases ABI were <0.70,and 54 cases ABI were 0.70-0.90.There were 29 cases(43.3%) of unilateral lower extremity lesions and 38 cases(56.7%) of bilateral lower extremity lesions.The most severe stenosis sites were 21 cases femoral popliteal artery,37 cases tibiofibular artery and 9 cases dorsal pedis artery.The results of multivariate analysis showed that smoking,hypertension,CRP,LDL-C and paresthesia of lower extremity were all risk factors for lower extremity arterial disease in newly diagnosed T2DM patients(P<0.05).Conclusion There is a high proportion of newly diagnosed T2DM patients with lower extremity arterial disease.Smoking,hypertension,elevated CRP,elevated LDL-C,and lower extremity paresthesia are all risk factors for lower extremity arterial disease in newly diagnosed T2DM patients.Clinical evaluation and follow-up targeted examination can be conducted based on the above factors.

关 键 词：初诊 糖尿病 下肢动脉病变 临床特征 

分 类 号：R543[医药卫生—心血管疾病]