CAJ | 학술논문

目的调查2型糖尿病患者下肢血管病变发生率及其相关因素.方法于北京地区5所医院对随机选择所在医院随诊1年以上,发病年龄≥40岁,病程≥5年的2型糖尿病患者393例,进行病史回顾,体格检查,生化检查和下肢血管多普勒超声检查.结果393例患者中下肢坏疽8例(2.0%),间歇性跛行28例(7.1%).超声多普勒检查提示有不同程度下肢血管病变者357例(90.8%),其中以68例(17.8%)踝/肱动脉压比值＜1.0者与以下临床情况相关明显:糖尿病肾病和视网膜病变发生率高(P＜0.05),FBS和HbAlc水平高(P＜0.05),HDL-ch水平低(P＜0.05),舒张压高0P＜0.01).且踝/肱比值与FBS、HbAlc、Tg、纤维蛋白原、血压呈负相关,与HDL-ch呈正相关0P＜0.05).结论 2型糖尿病患者下肢血管病变常见,与血糖、血脂、血压以及血凝多种因素有关.超声多普勒检查能较早地发现病变,而踝/肱比值是下肢血管病变的一种方便可行和可靠的检测指标.
목적조사2형당뇨병환자하지혈관병변발생솔급기상관인소.방법우북경지구5소의원대수궤선택소재의원수진1년이상,발병년령≥40세,병정≥5년적2형당뇨병환자393례,진행병사회고,체격검사,생화검사화하지혈관다보륵초성검사.결과393례환자중하지배저8례(2.0%),간헐성파행28례(7.1%).초성다보륵검사제시유불동정도하지혈관병변자357례(90.8%),기중이68례(17.8%)과/굉동맥압비치＜1.0자여이하림상정황상관명현:당뇨병신병화시망막병변발생솔고(P＜0.05),FBS화HbAlc수평고(P＜0.05),HDL-ch수평저(P＜0.05),서장압고0P＜0.01).차과/굉비치여FBS、HbAlc、Tg、섬유단백원、혈압정부상관,여HDL-ch정정상관0P＜0.05).결론 2형당뇨병환자하지혈관병변상견,여혈당、혈지、혈압이급혈응다충인소유관.초성다보륵검사능교조지발현병변,이과/굉비치시하지혈관병변적일충방편가행화가고적검측지표.
Objective To investigate the prevalence of vascular disease in the lower extremities and its related risk factors in type 2 diabetic patients.Methods A total of 393 type 2 diabetic patients treated in 5 hospitals in Beijing were randomly recruited for the study with their age of more than 40 years at onset,diabetes duration of more than 5 years and treatment for more than 1 year in each hospital.The case history,physical examination,biochemical tests and ultrasonic Doppler examination were conducted in these patients.Results Eight patients had gangrene (2.0%) and 28(7.1%) had intermittent claudication in 393 diabetics,while ultrasonic examination showed that 357 cases (90.8%) had vascular lesions in the lower limbs.Ankle/brachial systolic pressure ratio (API,Ankle pressure index) less than 1.0 was found in 68 cases (17.8%).The higher prevalence of diabetic nephropathy and retinopathy,higher fasting blood sugar and HbAlc,higher diastolic pressure and lower HDL ch levels ( P <0.05) were significantly correlated with API less than 1.0.Their API was in negative relationship with the fasting blood sugar,HbAlc,triglyceride,fibrinogen levels and blood pressure,and in positive relationship with HDL ch levels ( P <0.05).Conclusion Vascular lesions in lower limbs were common in type 2 diabetes mellitus.These lesions could be found earlier with the ultrasonic Doppler examination.