2型糖尿病下肢血管病变发生率及相关危险因素分析

目的了解2型糖尿病患者下肢血管病变的发生率，分析其相关危险因素。方法用高分辨率彩色多普勒超声对120例住院2型糖尿病患者进行下肢血管检查，同时检测血糖、糖化血红蛋白（HbAlc）、血脂、纤维蛋白原（Fib）和24h尿蛋白排泄率（uAE），观察患者的年龄、病程和发生周围神经病变（DPN）的比例。结果经多普勒超声检查提示有不同程度下肢血管病变者79例（占65、8％），其中重度血管病变组28例（A组）、轻中度血管病变组5l例（B组），无血管病变组4l例（c组）。有下肢血管病变组的年龄、病程、HbAIC、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、Fib、UAE和DPN发生的比例均显著高于无病变组（C组），P〈0．01；而年龄、LDL—C、Fib和UAE在A组高于B组，P〈0．01或P〈0．05。结论2型糖尿病患者下肢血管病变的发生率高，年龄、病程、HbAIC、TC、LDL—C、Fib、UAE和DPN是2型糖尿病患者下肢血管病变的危险因素。

Analysis of incidence of vascular change at lower extremities in type 2 diabetic patients and relevant risk factors

Objective To investigate the prevalence of vascular disease in the lower extremities and its related risk factors in type 2 diabetic patients. Methods There 120 cases patients with type 2 diabetes were detected by high resolution color Doppler ultrasonography, and the levels of blood glucose, glycosylated hemoglobin （HbAlc）, serum lipids, fibrinogen and urinary albumin excretion （UAE） in 24 hours were examined. Results Various degrees of vascular lesions were observed in the lower limbs of 79 cases （65.8%）, Severe and mild lesions were observed in 28 amd 51 cases, and 41 cases without vascular disease in the lower extremities . The age, duration of disease, the levels of fibrinogen, HbAlc, UAE in 24 hours, total cholesterol, low density lipoprotein- C and the aceurrenee of diabetic peripheral neuropathy （DPN） in the diabetic patients with peripheral vascular disease （PVD） were significantly higher than those without PVD （P 〈 0.01）, while the age, levels of fibrinogen, UAE in 24 hours, low density lipoprotein - C severe cases were significantly higher than that of mild cases （P 〈 0.05）. Conclusion The incidence of vascular lesions in lower limbs in type 2 diabetic patients is high, and the age, duration of disease, levels of fibrinogen, HbAlc, UAE in 24 hours , total cholesterol, low density lipoprotein - C and DPN in type 2 diabetic patients are risk factors of vascular diseases in lower extremities.