严重下肢动脉病变与糖尿病足的相关性研究

目的 调查住院病人糖尿病足(DF)和下肢动脉病变(PAD)的发病情,分析两者之间的相关性.方法 测定523例住院糖尿病病人空腹及餐后血糖、HbA_(1C)血脂分析和尿微量白蛋白浓度等.应用多普勒超声技术评估所有糖尿病住院病人PAD病情,检查股动脉、股浅动脉、胭动脉、胫前动脉、胫后动脉和腓动脉.根据检查结果分为3组:无病变组、轻度病变组(血管狭窄<50%)和重度病变组(血管狭窄≥50%).糖尿病足诊断按照Wagner标准.结果 在凶糖尿病住院523例病人中,DF 95例(18.2%).PAD 311例(59.5%),其中重度PAD 131例(25.0%).95例DF病人中重度PAD 55例(57.9%).Log9istic回归分析显示,严重PAD(OR=5.00)是DF的独立危险因素.其他危险因素包括吸烟、高血压和糖尿病神经病变.结论 严重PAD是DF最主要的危险因素.

Study on the relationship between severe peripheral arterial occlusive disease and diabetic foot

Objective To investigate the prevalence of peripheral arterial occlusive disease(PAD)and diabetic foot among in-patients with diabetes,and to analyze the relation between these two complications.Methods Five-hundred and twenty-three patients with type 2 diabetes were enrolled.Fasting and postprandial plasma glucose,HbA_(1C),serum lipid profile and urinary albumin were determined.Femoral artery,profunda femoraJ artery.popliteal anory,anterior tibial artery,posterior tibial artery,and peroneal artery were checked by Doppler ultrasonographv.The patients were then subdivided into groups with non-PAD,mild PAD(artery stenesis<50%)and severe PAD(anery stenosis≥50%).Diabetic foot was diagnosed using Wagner criterion.Results Among the 523 palients.95 patients were afflicted with diabetic foot,311 patients with PAD in which 131 with severe PAD.As many as 55 severe PAD cases were found in diabetic foot patients.Multivariate logistic regression analysis revealed that severe PAD was significantly associated with diabetic foot(OR=5.00),other risk factors included smoking habit, hypertension and neuropathy. Conclusion Severe PAD seems to be the most important risk factor related to diabetic foot.