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2型糖尿病下肢血管病变发生率及相关因素调查
引用本文:潘长玉 高妍 袁申元 李光伟 王 陆菊明 李俊来 杨国庆 张俊清 陈铭 朱良湘 刘效慈 肖平 张学文 肖新华 李文慧 姜育新. 2型糖尿病下肢血管病变发生率及相关因素调查[J]. 中国糖尿病杂志, 2001, 9(6): 323-326
作者姓名:潘长玉 高妍 袁申元 李光伟 王 陆菊明 李俊来 杨国庆 张俊清 陈铭 朱良湘 刘效慈 肖平 张学文 肖新华 李文慧 姜育新
作者单位:潘长玉(解放军总医院内分泌科,邮政编码,100853)      高妍(北京大学第一医院)      袁申元(北京同仁医院)      李光伟(卫生部中日友好医院)      王(heng)(中国医学科学院,中国协和医科大学,北京协和医院)      陆菊明(解放军总医院内分泌科,邮政编码,100853)      李俊来(解放军总医院内分泌科,邮政编码,100853)      杨国庆(解放军总医院内分泌科,邮政编码,100853)      张俊清(北京大学第一医院)      陈铭(北京大学第一医院)      朱良湘(北京同仁医院)      刘效慈(北京同仁医院)      肖平(北京同仁医院)      张学文(卫生部中日友好医院)      肖新华(中国医学科学院,中国协和医科大学,北京协和医院)      李文慧(中国医学科学院,中国协和医科大学,北京协和医院)      姜育新(中国医学科学院,中国协和医科大学,北京协和医院)
基金项目:本研究得到天津大塜制药公司资助
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28例(7.1%).超声多普勒检查提示有不同程度下肢血管病变者357例(90.8%),其中以68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<0.05),FBS和HbAlc水平高(P<0.05),HDL-ch水平低(P<0.05),舒张压高0P<0.01).且踝/肱比值与FBS、HbAlc、Tg、纤维蛋白原、血压呈负相关,与HDL-ch呈正相关0P<0.05).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.

关 键 词:2型糖尿病 大血管病变 超声波检查

The prevalence of vascular lesions in the lower extremities and their risk factors in type 2 diabetic mellitus
Pan Changyu,Gao Yan,Yuang Shenyuan,et al. The prevalence of vascular lesions in the lower extremities and their risk factors in type 2 diabetic mellitus[J]. Chinese Journal of Diabetes, 2001, 9(6): 323-326
Authors:Pan Changyu  Gao Yan  Yuang Shenyuan  et al
Abstract: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.
Keywords:Type 2 diabetes Macroangiopathy Ultrasound
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