2型糖尿病合并高血压下肢动脉硬化闭塞症临床分析-第三军医大学学报.doc

2型糖尿病合并高血压下肢动脉硬化闭塞症临床分析 马晓兰1，沈建国1，吕海宏2，孙 燕1，冯云飞1，胡金星1（310003杭州，浙江大学第一附属医院内分泌科1； 730000，兰州，兰州大学第一附属医院内分泌科2） [摘要]目的 探讨老年2型糖尿病合并高血压患者下肢动脉硬化闭塞症的临床特点。方法 回顾分析2004年1月至2010年12月浙医一院内分泌科及血管外科住院下肢动脉硬化闭塞症患者319例,其中男223例，女96例，平均年龄68岁以上。根据既往有无高血压及糖尿病分为对照组（无高血压及糖尿病，n=50）、糖尿病组（DM组，n=48）、高血压组（HNT组，n=80）、糖尿病合并高血压组（DM-HNT组，n=141），均初步行彩色多普勒超声检查或磁共振动脉成Logistic回归方法进行分析。结果 ①DM-HNT组年龄、空腹血糖、糖化血红蛋白、血压、心血管及脑血管并发症发生率均高于对照组（P＜0.01）；与其他3组相比，DM-HNT组TG、TC及LDL-C显著较高（P＜0.05）而HDL-C显著较低（P＜0.05）；DM-HNT组糖尿病病程明显较DM组长（P＜0.05）；②DM-HNT组髂、股、小腿动脉段闭塞率分别为41.4%、72.7%、75.6%，显著高于HNT 组（27.2%、41.3%、28.3%，P＜0.05）及对照组（19.7%，27.9%，16.4% ，P＜0.01）。DM-HNT组髂、股动脉段闭塞率显著高于DM组（P＜0.05），但小腿动脉段闭塞率无差异（P＞0.05）。③多因素Logistic回归分析显示 [关键词]下肢动脉硬化闭塞；2型糖尿病；高血压 Lower Extremity Arterial Occlusive Disease in patients with type 2 diabetes mellitus and hypertension. Ma Xiaolan1，Shen Jianguo1，Lu Haihong2，Sun Yan1，Feng YunFei1，Hu Jinxin1 （1Department of endocrinology and metabolism， the First Affiliated Hospital， School of Medicine， Zhejiang University， Hangzhou 310003Department of endocrinology and metabolism， the First Affiliated Hospital， School of Medicine， University， nzhou 730000， ChinaAbstract] Objective To investigate clinical features of lower extremity atherosclerotic occlusive disease in patients with type 2 diabetes mellitus and hypertension. Methods We performed a retrospective analysis of 319 patients with lower extremity atherosclerotic occlusive disease who were hospitalized in department of endocrinology and vascular surgery of the First Affiliated Hospital, School of Medicine, Zhejiang University, between January 2004 to December 2010, Those were divided into four groups: control group（without hypertension diabetes, n=50）diabetes group（type 2 diabetes, DM, n=48）hypertension group（HNTn=80）, diabetes and hypertension group（DM-HNTn=141. All these patients were checked by 1ower limbs color Doppler ultrasound or magnetic resonance angiography(MRA); and 248 patients（248/319）took the arteriography on lower extremity. The differenc