踝肱指数在诊断2型糖尿病患者下肢动脉病变中的临床意义

目的:了解踝肱指数(ABI)在诊断2型糖尿病下肢动脉病变(LEAD)的临床意义和影响因素。方法:对231例2型糖尿病患者测定ABI,以ABI值0.9为异常分为LEAD组(46例)和非LEAD组(对照组,185例),所有患者均进行体重量指数,腰臀比,血糖、血脂、血压、尿微量白蛋白等检查,并对其结果进行分析。结果:在231例2型糖尿病患者中,46例ABI0.9的LEAD患者的病程(9.1±6.3)年:(4.5±5.7)年]、糖化血红蛋白10.9±3.3)%:7.8±1.2)%]、低密度脂蛋白-胆固醇(3.1±0.9)mmol/L:(2.6±1.1)mmol/L]及脉压(59±15)mmHg:(52±14)mmHg],均明显高于对照组(P均0.05)。结论:糖尿病合并下肢动脉病变者具有病程长、血糖高、脉压差大、血脂紊乱等特点,踝肱指数是一项花费小、简单无创的诊断下肢动脉病变的可靠指标。

Clinical significance of ankle-brachial index in diagnosis of peripheral artery disease in patients with type 2 diabetes

Objective：To investigate the clinical significance and affected factors of ankle-brachial index（ABI） in the diagnosis of lower extremity artery disease（LEAD） in patients with type 2 diabetes.Methods：ABI was examined in 231 patients with type 2 diabetes.According to the standard that ABI less than 0.9 was regarded as abnormal,the patients were divided into LEAD group（ABI〈0.9,46 cases） and control group（ABI≥0.9,185 cases）.All patients received the measurement of body mass index（BMI）,waist hip ratio（WHR）,blood glucose,blood lipid,blood pressure and unine microalbuminuria.The results were compared and analyzed.Results：The LEAD group had a longer course of disease （9.1±6.3） years vs.（4.5 5.7） years],higher levels of glycosylated hemoglobin HbA1C,（10.9±3.3）% vs.（7.8±1.2）%] and low density lipoprotein-cholesterol,larger pulse pressure （59 15） mmHg vs.（52±14） mmHg] than those of control group（P〈0.05 all）.Conclusion：Patients with type 2 diabetes company with peripheral artery disease possess characteristics of longer course of disease,higher level blood glucose,larger pulse pressure and more lipid dysfunction.It is easy and economical to check ankle-brachial index for diagnosing peripheral artery disease.