2型糖尿病合并外周动脉疾病危险因素分析

 目的 观察2型糖尿病患者合并外周动脉疾病(peripheral arterial disease,PAD)的发病情况,探讨2型糖尿病患者踝臂指数(ankle-brachial index, ABI)异常的危险因素.方法 414例2型糖尿病患者按踝臂指数<0.9和≥0.9分为外周动脉疾病组和非外周动脉疾病组,比较两组的临床特征,确定2型糖尿病合并外周动脉疾病的危险因素.结果 2型糖尿病患者合并PAD者为83例,总发病率为20.05%;PAD组平均年龄、糖尿病病程、总胆固醇、低密度脂蛋白胆固醇、冠心病、缺血性脑卒中高于非PAD组(P<0.05或P<0.01).多因素Logistic回归分析显示,年龄、糖尿病病程、总胆固醇、低密度脂蛋白胆固醇、冠心病、缺血性脑卒中是2型糖尿病合并外周动脉疾病的危险因素.结论 踝臂指数是筛查2型糖尿病合并外周动脉疾病的简单易行的可靠指标,年龄、糖尿病病程、总胆固醇、低密度脂蛋白胆固醇、冠心病、缺血性脑卒中是2型糖尿病踝臂指数降低的危险因素.

Risk factor analysis in type 2 diabetes mellitus with peripheral arterial disease

Objective To study the incidence of peripheral artery disease（PAD） in type 2 diabetes mellitus（T2DM） and risk factors in T2DM with abnormal ankle brachial index（ABI）. Methods 414 T2DM patients were divided into PAD group and non - PAD group according to the value of ABI （the cut point was O. 9）. The two groups were compared and the factors related to ABI were analyzed. The risk factors of PAD in T2DM were identified. Results There were 83 patients with PAD, an overall incidence of 20. 05%. In PAD group, the age（65. 892 ±9. 564 years vs 9. 979 ± 10. 226 years ,P 〈0.01 ） ,diabetes duration（87.67 ±49.49 month vs 55.95 ±56.26 months, P 〈0.01 ）, total cholesterol（5. 496 ± 1. 185mmoL/L vs 5. 215 ± 1. 158retool/L, P 〈0.05）, low density lipoprotein cholesterol（ LDL - c） （ 2.819 ± 0.78 mmot/L vs 2. 608 ± 0.671 mmol/1, , P 〈 0.05 ）, coronary heart disease （ 50.6% vs 34. 4%, P 〈0.01 ）, and ischemic stroke（ 19.28% vs 9.06%, P 〈0.01 ）were significanthy , and ABI（O. 82 ±0.09 vs 1. 007 ±0.08 ,P 〈 0.01 ）was significantly lower, than those in non- PAD group. Logistic regression analysis showed that age, diabetes mellitus, total cholesterol, LDL- C, coronary heart disease and ischemic stroke were major risk factors of PAD in T2DM. Conclusions ABI is a feasible and reliable index for screening PAD in T2DM patients. Age, diabetes mellitus, total cholesterol, LDL - C, coronary heart disease, and ischemic stroke are major risk factors of low ankle - brachial index in T2DM patients.