高龄老人2型糖尿病下肢血管病变相关因素分析

目的探讨75岁以上老人2型糖尿病(DM)患者下肢血管病变的相关因素。方法对门诊及住院的75岁以上2型DM患者131例进行详细病史调查及体格检查,并作生化及双下肢血管彩色多普勒超声检查,均有轻～重度下肢血管病变,另选择无下肢血管病变老年2型DM患者40例,分析临床因素及生化指标与下肢血管病变之间的相关性。结果 131例患者中,轻度血管病变者47例(35.8%),中度血管病变者42例(32.1%),重度血管病变者42例(32.1%)。患者下肢血管病变与年龄、糖尿病家族史、糖尿病病史、高血压病史、冠心病史、糖尿病周围神经病变、视网膜病变、糖尿病足、糖尿病肾病、空腹和餐后2 h血糖、糖化血红蛋白、尿白蛋白均呈正相关(r均>0.243,P<0.05或<0.01),与HDL-C呈负相关(r=-0.140,P<0.05)。结论高龄老人2型DM患者下肢血管病变同年龄、糖尿病病史、高血压、冠心病、血脂、血糖、蛋白尿等多种因素相关。

Analysis of related factors of the lower limbs artery disease in elder patients with type 2 diabetic disease

Objective To investigate the related factors of the lower extremities artery disease in over 75 years old patients with type 2 diabetic disease.Methods 131 patients were treated in outpatient department or admission were enrolled in present study.The clinical history,physical examination,biochemical tests and ultrasonic Doppler examination were took and recorded,all the patients complicated with lower limb artery disease,other 40 elder patients without lower limb artery disease were selected.The relationship between clinical factors,biochemical indicator and lower limbs artery disease were investigated. Results Ultrasonic examination showed 47 cases(35.8%) had mild degree lower limb artery disease,42 cases (32.1%) had moderate degree lower limb artery disease,and 42 cases(32.1%) had severe degree lower limb artery diseases. The lower limb vasculopathy was positively correlated with age,history of diabetes,hypertensive disease(HBP),coronary heart disease(CHD),peripheral neuropathy disease,diabetic retinopathy,diabetic foot,diabetic nephropathy,fasting and post-meal glucose,glycolated hemoglobin and urinary-albumin(all the r value were greater than 0.243,P < 0.05 or P < 0.01);and negatively correlated with the level of HDL-C levels(r = - 0.140,P < 0.05).Conclusion Vascular lesions of lower limbs in over 75 years old type 2 DM patients are correlated with multiple factors included age,history of diabetes,HBP, CHD,diabetic nephropathy,blood fat and serum glucose.