初诊Ⅱ型糖尿病患者踝肱动脉指数危险因素剖析.docVIP

初诊Ⅱ型糖尿病患者踝肱动脉指数危险因素剖析 　　[摘 要] 目的 研究踝肱动脉血压指数（ABI）在初诊中老年2型糖尿病（T2DM）患者下肢动脉病变(PAD)中临床意义与影响因素。方法 采用多普勒血流探测仪检测129例初诊中老年T2DM患者足背动脉、胫后动脉与肱动脉血压的比值，以0.9为切割点，分析比较中老年两组ABI及临床参数差别。结果 129例初诊中老年T2DM患者中ABI0.9为14例，占总数10.9%，老年组ABI、吸烟率、甘油三酯低于中年组，而PAD患病率、BMI、收缩压、高血压患病率、高血压病程、空腹血糖、餐后2小时血糖、HbA1c高于中年组，差异有统计学意义(p0.05)，ABI与年龄（r=-0.461,p=0.001）、高血压病程（r=-0.318,p=0.029）、HbA1c（r=-0.361,p=0.046）呈负相关，多元逐步回归分析显示年龄（p=0.02）、高血压病程（p=0.01）是ABI独立影响因素。结论 初诊中老年T2DM中ABI0.9者占10.9%，老年组患病率及危险因素高于中年组，年龄、高血糖、高血压为PAD的主要危险因素。 　　关键词 糖尿病 Ⅱ型 初诊 踝肱动脉血压指数 危险因素 　　 　　Difference and analysis of ankle-brachial index in the middle aged and older patients with type 2 diabetes newly diagnosed Zeng li Department of endocrinology,the third affiliated hospital of medical college of Nan Chang University,Nanchang 330008,China 　　[Abstract] Objective To investigate ankle-brachial index(ABI) in the diagnosis of peripheral artery disease (PAD)and its risk factors in the the middle aged and older patients with type 2 diabetes newly diagnosed. Methods The 129 newly diagnosed(duration≤6 months)patients with type 2 diabetes were divided into group A(the middle aged ,years 40-59) and group B(the older ,years ≥60).ABI and various parameters in two groups were examined and analysed by statistical methods. Results 14 patients(10.9%) showed abnormal ABI(ABI2）,higher systolic blood pressure(141.9±19.4 vs 128.3±20.0 mmHg),longer duration of hypertension(37.2±62.4 vs 13.2±22.8 months),higher fasting plasma glucose(11.8±4.4 vs 10.3±3.6 mmol/L), higher two-hour postprandial plasma glucose(18.3±5.8 vs 16.4±5.1 mmol/L)and higher levels of HbA1c(10.0±2.9 vs 8.4±2.1) in group B than in group A.ABI was in significant negative correlation with age, duration of hypertension and HbA1c.Step-wise analysis screened that age and duration of hypertension were the independent risk factors for PAD. Conclusions There are 10.9% patients with lower ABI in the newly diagnosed middle aged and older patients type 2 diabetes. Aging, hyperglycemia and hypertensio