糖尿病病人外周血管疾病危险因素指标踝/肱动脉收缩压比的评估研究

研究表明糖尿病病人动脉粥样硬化发病率较一般人群高。但其病因学机制尚不明了。本研究评估了患糖尿病的病人外周血管疾病(PVD)的危险因素。检测了65名糖尿病患者的血压、人类学指标、潜在的外周血管疾病生物化学的危险因素。取踝/肱动脉收缩压比(ABR)<0.9作为判定PVD的指标。ABR与如下指标明显相关,年龄(r=-0.46,p<0.001),肌酐(r=-0.37,p<0.02),纤维蛋白原(r=-0.53,p<0.001),总同型半胱胺酸(tHcy)(r=-0.45,p<0.001)。通过逐步多元回归分析,如下因素为ABR的独立判定指标,血浆纤维蛋白原(β系数-0.47,p<0.001),tHcy(p系数-0.471,p=0.001)及尿酸盐(β系数0.279,p=0.031),公式如下:(ABR=1-0.669×血浆纤维蛋白原-0.450×tHcy+0.449×尿酸盐,p<0.001)。综上所述,在糖尿病病人中血浆蛋白纤维蛋白原,同型半胱胺酸尿、尿酸盐及血压为PVD发展的重要因素。

EVALUATION OF RISK FACTORS FOR THE MARKER OF PERIPHERAL VASCULAR DISEASE-ANKLE VERSUS BRACHIAL ARTERIAL-SYSTOLIC PRESSURE RATIO IN PATIENTS WITH DM IN CHINESE

A higher prevalence of atherosclerosis has been observed in subjects with diabetes than in the general population.However,the pathogenic mechanisms underlying this relationship remain to be determined.In this study,we evaluated the risk factors attributed to peripheral vascular disease(PVD)in diabetic Chinese patients.Blood pressure(BP),anthropometric,and potential biochemical risk factors for PVD were measured in 65 diabetic Chinese patients.The arterial-systolic pressure ratio(ABR)was used as an index of PVD with an ABR<0.9 indicative of PVD.The ABR significantly correlated with age(r=-0.46,p<0.001),creatinine(r=-0.37,p=0.002),fibrinogen(r=-0.53,p<0.001),total homocysteine(tHcy)(r=-0.45,p<0.001)and systolic blood pressure(r=-0.42,p<0.001).Using stepwise multiple regression analyses,plasma fibrinogen(beta coefficient-0.407,p<0.001),tHcy(beta coefficient-0.471,p=0.001),and urate(beta coefficient 0.279,p=0.031)were found to be independent predictors of the ABR in patients(ABR=1-0.669×fibrinogen-0.450×tHcy+0.449×urate,p<0.001).In summary,fibrinogen,tHcy,and urate as well as blood pressure were found to be important factors related to the development of PVD in this population of diabetic Chinese patients.