2型糖尿病患者下肢动脉病变血管造影的特征

目的对2型糖尿病患者行下肢动脉血管造影,以了解其动脉病变的分布特征及与临床表现的关系。方法对60例2型糖尿病患者和14例非糖尿病患者行下肢动脉血管造影检查,并计算受累病变支数和采用10分段积分法评估动脉管腔狭窄程度。结果糖尿病组下肢动脉病变累及的血管支数中位数为5支,显著高于非糖尿病组的2支(P<0.01)。除腹主动脉外,糖尿病组发生在同节段的双侧病变支数累计为71支,显著高于非糖尿病组的4支(P<0.05),而单侧支数的差异无统计学意义(P>0.05)。两组间腓、胫后动脉积分的差异均有统计学意义(P值均<0.05)。两组间膝以上动脉病变累计积分的差异无统计学意义(P>0.05),而糖尿病组膝以下动脉病变累计积分显著高于非糖尿病组(P<0.05)。糖尿病组腘、腓和胫后动脉的病变发生率分别为43.3%、53.3%和50.0%,均显著高于非糖尿病组的7.1%、21.4%和14.3%(P值均<0.05)。年龄、低密度脂蛋白胆固醇(LDL-C)与下肢动脉病变呈显著正相关(P值均<0.05)。结论与非糖尿病患者相比,2型糖尿病患者在远端节段下肢动脉病变较为严重和广泛,而近端节段无明显差异。年龄、LDL-C均是下肢动脉病变的危险因素。

Distribution of the arterial lesions in type 2 diabetic patients with lower extremity arterial disease: an angiographic study

Objective To investigate the distribution of the arterial lesions in lower extremity through angio- graphy and explore its correlation with the clinical manifestations in patients with type 2 diabetes mellitus. Methods Angiography of the lower extremity arteries was performed in 60 type 2 diabetic patients and 14 non-dia- betic patients.The lower extremity arteries,divided into 10 segments from the abdominal aorta to the posterior ti- bial artery,were assessed for stenosis according to the scores of the individual segments,and the involved arteries were counted.Results The diabetic patients showed significantly greater overall number of the involved arteries(5 branches)than the non diabetic patients(2 branches,P<0.01).Significant differences were found between the two groups in the number of involved arteries(P<0.05)in the same segments bilaterally except for the abdominal aorta segment,but comparison for the unilateral segments did not suggest such a difference(P>0.05).The scores for popliteal artery(P=0.05)and posterior tibial artery(P<0.05)stenosis were significantly different between the two groups,and the diabetic group had significantly higher accumulative scores for arterial stenosis below the knee level(including the popliteal artery,P<0.05),but not for the arteries above the knee(P>0.05).The dia- betic patients had also higher incidences of lesions than the non-diabetic patients in the popliteal(43.3% vs 7.1%), peroneal(53.3% vs 21.4%),and posterior tibial arteries(50.0% vs 14.3%,all P<0.05).Logistic analysis re- vealed a positive correlation of age and low-density lipoprotein cholesterol with lower extremity arterial lesions(all P<0.05).Conclusions Compared to the non-diabetic patients,type 2 diabetic patients are liable to severe and extensive vascular lesions-in the distal segments of the lower extremity.