踝肱指数对糖尿病血管合并症的预测和诊断意义

目的:探讨踝肱指数诊断糖尿病患者血管并发症的效力,初步探讨不同踝肱指数界点对合并症预测的差异。方法:分析277例2型糖尿病患者的踝肱指数检测值,分别进行常规标准分组[≤0.90设为外周动脉疾病(PAD)组,0.91～1.30为非PAD组,>1.30为动脉硬化组]与自定标准分组(≤1.0为PAD组’,1.10～1.40为非PAD组’,>1.40为动脉硬化组’),比较不同程度踝肱指数分组间临床参数及血管并发症发生率的差异。结果:与其他组患者比较,踝肱指数≤0.9的糖尿病患者,其年龄大,病程长,餐后血糖、收缩压较高,心血管、肾脏疾病和糖尿病足发病率均明显增高;而踝肱指数≤1.0和>1.4均可能与糖尿病足的发生有关系。结论:踝肱指数与糖尿病大血管并发症的发生密切相关;临床在应用其预测糖尿病足发生时可能宜放宽诊断标准至≤1.0,以利早期预防。

Ankle brachial index in the prediction and diagnosis of diabetic vascular complications

Objective：To investigate the influencing factors and diagnostic effectiveness of ankle brachial index（ABI） in diabetic vascular complications.Methods：The ABI value was examined in 277 patients with type 2 diabetes.Clinical data and conditions of vascular complications were compared among 3 groups with different ABI value.Results：Forty-four patients（15.9 %） with ABI ≤0.9 were at older age,with longer duration of diabetes,higher level of 2 h post-meal blood glucose and systolic blood pressure,higher incidence rates of cardiovascular disease,and renal disease and diabetic foot.Groups with ABI≤1.0 and 1.4 are both related to incidence of diabetic foot.Conclusion：ABI is closely related to diabetic macrovascular complications,and the diagnostic criteria should be adjusted to ≤1.0 especially for preventing diabetic foot.