糖尿病对股胭动脉腔内治疗预后的影响

目的探讨糖尿病对下肢动脉硬化闭塞症（股胭动脉节段）腔内治疗效果的影响。方法2009年1月1日～2012年8月1日，对我院接受股、胭动脉腔内介入治疗的患者按是否合并糖尿病，分为糖尿病组与非糖尿病组，其中糖尿病组94例（109条肢体），非糖尿病组84例（94条肢体）。比较2组患者围手术期情况、一期通畅率，应用Kaplan—Meier方法计算一期通畅率，COX回归分析影响预后的相关危险因素。结果糖尿病组与非糖尿病组围手术期局部并发症发生率3．7％（4／109）vs．3．2％（3／94），P=1．000]、系统并发症发生率3．9％（4／103）vs．3．4％（3／88），P=1．000]均无明显差异。糖尿病组3、6、12、24、36个月的一期通畅率分别为（93．8±2．5）％，（80．7±4．2）％，（71．7±5．1）％，（66．0±5．7）％，（66。0±5．7）％；非糖尿病组3、6、12、24、36个月的一期通畅率分别为（97．6±1．6）％，（89．1±3．4）％，（84．5±4．2）％，（79．8±5．1）％，（75．6±6．4）％，2组比较无统计学差异（10g—rank检验，z。=3．052，P=0．081）。COX回归分析显示，2型糖尿病（RR=2．182，95％们：1．13～4．22）、高脂血症（RR=1．904，95％叫：1．02～3．56）及TASCⅡC、D级病变（RR=2．322，95％C1：1．20～4．49）是影响一期通畅率的危险因素。结论对于合并糖尿病的股胭动脉硬化闭塞症患者，腔内介入治疗是一种安全、有效的治疗方法。糖尿病是影响股、胭动脉腔内介入治疗一期通畅率的危险因素，其他影响一期通畅率的危险因素包括TASCⅡC、D级病变及高脂血症。

Impact of Diabetes Meilitus on the Prognosis of Endovascular Treatment of Femoropopliteai Arteries

Objective To evaluate the impact of diabetes mellitus on femoropopliteal endovascular interventions. Methods Data of patients with femoropopliteal atherosclerotic diseases treated with endovascular interventions between January 2009 and August 2012 in Peking Union Medical College Hospital were retrospectively collected. The patients were divided into two groups： 94 patients （109 limbs ） in the diabetic group and 84 patients （94 limbs ） in the non-diabetic group. Clinical characteristics and perioperative complications were retrospectively analyzed between the groups. Kaplan-Meier method was used to calculate primary patency rates, and cox-regression analysis was used to analyze risk factors affecting primary patency. Results The local complication rates were 3.7% （4/109） in the diabetic group and 3.2% （3/94） in the non-diabetic group （P = 1. 000）. The systemic complication rates were 3.9% （4/103） in the diabetic group and 3.4% （3/88） in the other group （P = 1. 000）. Primary patency rates at 3, 6, 12, 24 and 36 months were （93.8±2.5）%, （80.7±4.2）%, （71.7±5.1）%,（66.0±5.7）%, （66.0 ±5.7）% respectively in the diabetic group and （97.6±1.6）%, （89.1±3.4）%, （84.5 ±4.2）%, （79.8±5.1）%, （75.6±6.4）% respectively in the non-diabetic group. There was no statistical difference between the two groups （X2 = 3. 052 ,P =0. 081 ）. However; cox-regression analysis showed that type I1 diabetes mellitus （ RR = 2.182, 95 % CI： 1.13 - 4.22）, hyperlipidemia （ RR = 1.90, 95 % CI： 1.02 - 3.56 ） and TASC I/ C/D lesions （ RR = 2.32, 95% CI： 1.20 - 4.49 ） were risk factors affecting primary patency rate. Conclusions Endoluminal treatment of femoropopliteal atherosclerotie lesions in diabetic patients is safe and effective. Diabetes mellitus is one of the risk factors adversely affecting primary patency rate along with hyperlipidemia and TASC II C/D lesions.