2型糖尿病下肢血管病变的临床流行病学分析

目的了解2型糖尿病下肢血管病变的发生情况、临床特征等,并探讨其危险因素。方法收集2型糖尿病患者身高、体重和糖尿病病程等一般临床资料,检测炎症因子、血糖和胆固醇等常规临床生化指标,测定踝肱指数,进行下肢血管彩色多普勒超声检查。结果 1 253名2型糖尿病患者中发生下肢血管病变者564例（45.01%）。下肢血管病变组年龄、糖尿病病程和体质指数高（t=16.13、19.59和7.83,均有P〈0.05）,超敏C反应蛋白（high sensitive C-reactive proteins,hsCRP）、空腹血糖（fasting blood glucose,FBG）、糖化血红蛋白（hemoglobin A1c,HbA1c）、总胆固醇（Total Cholesterol,TC）和甘油三酯（triglyceride,TG）等也高（t=55.80、10.70、14.64、2.47和8.35,均有P〈0.05）,高密度脂蛋白胆固醇（high-density lipoprotein cholesterol,HDL-C）则低（t=-3.83,P〈0.05）;Logistic回归分析显示,随着糖尿病病程、hsCRP、TC/HDL-C比值和HbA1c的增加,糖尿病下肢血管病变发生危险增加（均有P〈0.05）。结论 2型糖尿病下肢血管病变发生率高,糖尿病病程、hsCRP、TC/HDL-C比值和HbA1c是糖尿病下肢血管病变的危险因素。

Clinical epidemiological analysis of type 2 diabetes patients with peripheral artery disease

Objective To study the incidence,clinical features and potential risk factors for type 2 diabetes patients with peripheral artery disease（ PAD）. Methods Interview was conducted to collect informations on the general clinical data such as height,weight and course of disease. Serum levels of high-sensitivity C-reactive protein（ hsCRP）,bloodglucose and cholesterol were detected. Ankle brachial index（ ABI） and color Doppler ultrasonography of peripheral artery were also determined. Results Among the 1 253 study subjects,PAD accounted for 45. 01%. Compared with those without PAD,age,course of disease and body mass index increased（ t = 16. 13,19. 59 and 7. 83,all P 0. 05）,levels of high-sensitivity C-reactive protein（ hsCRP）,fasting blood-glucose（ FBG）,total cholesterol（ TC）,triglyceride（ TG）,and glycosylated hemoglobin（ HbA1c） increased（ t = 55. 80,10. 70,14. 64,2. 47 and 8. 35,all P 0. 05）,level of high-density lipoprotein cholesterol（ HDL-C） decreased（ t =- 3. 83,P 0. 05）. Multivariate Logistic regression analysis showed that course of disease,level of hsCRP and HbA1c,and TC/HDL-C were risk factors（ all P 0. 05）. Conclusions The incidence of peripheral artery disease was high among patients with type 2 diabetes mellitus. Course of disease,level of hsCRP and HbA1c,and TC/HDL-C were risk factors for type 2 diabetes mellitus with PAD.