CAJ | 학술논문

目的应用多普勒仪检测踝肱指数、趾肱指数,评估老年2型糖尿病患者周围血管功能状态,探讨踝肱指数、趾肱指数对老年2型糖尿病患者血管病变的变化及其相关因素的关系.方法检测128例2型糖尿病患者与103例对照组患者下肢血管多普勒频谱,测定肱动脉压及踝压,并计算ABI、TBI值,同时测定体重指数、血压、血脂、hs-CRP等,并结合患者年龄、病程等因素进行统计学分析比较.结果 (1)2型糖尿病组ABI、TBI值降低,hs-CRP升高,与对照组比较差异有统计学意义(P<0.05).(2)多元逐步回归分析显示ABI值、TBI值与年龄、收缩压、糖尿病病程呈负相关,ABI与HDL呈正相关.(3)logistic回归分析显示吸烟史、年龄、高血压及糖尿病病程对PVD影响的相对危险度分别为1.94(P<0.05)、2.12(P<0.01)、2.74(P<0.05)和1.59(P<0.05).结论多普勒仪可早期诊断糖尿病患者血管病变.高龄、糖尿病病程、吸烟、高血糖、高血压、低HDL及高hs-CRP水平可能影响糖尿病PVD的发生发展.
목적 응용다보륵의검측과굉지수、지굉지수,평고노년2형당뇨병환자주위혈관공능상태,탐토과굉지수、지굉지수대노년2형당뇨병환자혈관병변적변화급기상관인소적관계.방법 검측128례2형당뇨병환자여103례대조조환자하지혈관다보륵빈보,측정굉동맥압급과압,병계산ABI、TBI치,동시측정체중지수、혈압、혈지、hs-CRP등,병결합환자년령、병정등인소진행통계학분석비교.결과 (1)2형당뇨병조ABI、TBI치강저,hs-CRP승고,여대조조비교차이유통계학의의(P<0.05).(2)다원축보회귀분석현시ABI치、TBI치여년령、수축압、당뇨병병정정부상관,ABI여HDL정정상관.(3)logistic회귀분석현시흡연사、년령、고혈압급당뇨병병정대PVD영향적상대위험도분별위1.94(P<0.05)、2.12(P<0.01)、2.74(P<0.05)화1.59(P<0.05).결론 다보륵의가조기진단당뇨병환자혈관병변.고령、당뇨병병정、흡연、고혈당、고혈압、저HDL급고hs-CRP수평가능영향당뇨병PVD적발생발전.
Objective To evaluate the function of peripheral vessels, the change of ankle-brachial Index (ABI) and toe-brachial Index (TBI), and its related risk factors in elderly type 2 diabetic patients were observed. Methods Doppler frequency spectrum was used on lower limb of 128 type 2 diabetic patients and 103 non-diabetic people. ABI and TBI were calculated, other indexes including body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), hypersensitivity C-reactive protein(hs-CRP), triglyceride (TG), total cholesterol (TC), high density lipopretein (HDL), low density lipoprotein (LDL), fasting blood glucose(FBG), postprandial blood glucose (PPBG) and glycosylated hemoglobin (HbAlC) were measured. Results ABI and TBI were decreased in T2DM group as compared with control group (P<0.05), and hs-CRP was increased in T2DM group. With multiple stepwise regression, it showed that ABI and TBI was negatively related with age, SBP and T2DM duration, while ABI was positively correlated with HDL. In multiple logistic regression, cigarette, age, high blood pressure(HBP) and T2DM duration were independent risk factors with respective odds ratios of 1.94 (P<0.05), 2.12(P<0.01), 2.74(P<0.05) and 1.59(P<0.05), respectively. Conclusion Older age, T2DM duration, ciga-rette, hyperglycosema, HBP, low HDL and high bs-CRP play important roles in the occurrence and development of peripheral vascular dis-ease (PVD) in elderly type 2 diabetic patients. PVD of type 2 diabetic patients can be found earlier with Doppler diagnostic instrument.