CAJ | 학술논문

目的横断面评估住院2型糖尿病(T2DM)患者下肢血管病变(LEAD)患病率并分析其危险因素,为临床预防LEAD提供依据. 方法收集2012年6月至2013年6月我院住院664例T2DM患者临床资料及治疗情况,包括年龄、性别、糖尿病病程、体质指数、吸烟、空腹及餐后血糖、糖化血红蛋白、血脂、肾功能、纤维蛋白原、颈部超声、下肢血管超声、踝肱指数及治疗等进行统计分析,通过Logistic多元回归筛查LEAD危险因素. 结果符合LEAD诊断标准者247例,患病率达37.2％.不同T2DM病程LEAD患病率为,≤5年23.1％,5～10年27.9％,10～15年38.7％,15～20年51.2％,≥20年62.3％,差异有统计学意义(P＜0.05).LEAD组使用降压药物者占73.2％,其中他汀类药物者占54.6％,总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和三酰甘油(TG)达标率分别为56.3％、39.3％、47.4％和61.5％;非LEAD组使用降压药物者占77.2％,其中他汀类药物者占44.1％,TC、LDL-C、HDLC和TG达标率分别为45.1％、34.5％、35％和49.4％;两组比较,除LDL-C达标率外,差异均有统计学意义(P＜0.05).两组年龄、体质指数、高血压、冠心病、脑血管病、颈动脉增厚、颈动脉斑块形成、颈动脉狭窄、颈动脉闭塞差异均有统计学意义(均P＜0.05).经Logistic多元回归分析筛查LEAD危险因素有:年龄、糖尿病史、脑血管病史、颈动脉斑块形成、颈动脉狭窄. 结论 LEAD患病率37.2％,患者年龄、糖尿病史、脑血管病史、颈动脉斑块形成、颈动脉狭窄为LEAD的危险因素,而传统动脉硬化危险因素(高血压、TC、LDL-C、吸烟、非药物干预)是T2DM患者LEAD的危险因素.
목적 횡단면평고주원2형당뇨병(T2DM)환자하지혈관병변(LEAD)환병솔병분석기위험인소,위림상예방LEAD제공의거. 방법 수집2012년6월지2013년6월아원주원664례T2DM환자림상자료급치료정황,포괄년령、성별、당뇨병병정、체질지수、흡연、공복급찬후혈당、당화혈홍단백、혈지、신공능、섬유단백원、경부초성、하지혈관초성、과굉지수급치료등진행통계분석,통과Logistic다원회귀사사LEAD위험인소. 결과 부합LEAD진단표준자247례,환병솔체37.2％.불동T2DM병정LEAD환병솔위,≤5년23.1％,5～10년27.9％,10～15년38.7％,15～20년51.2％,≥20년62.3％,차이유통계학의의(P＜0.05).LEAD조사용강압약물자점73.2％,기중타정류약물자점54.6％,총담고순(TC)、저밀도지단백담고순(LDL-C)、고밀도지단백담고순(HDL-C)화삼선감유(TG)체표솔분별위56.3％、39.3％、47.4％화61.5％;비LEAD조사용강압약물자점77.2％,기중타정류약물자점44.1％,TC、LDL-C、HDLC화TG체표솔분별위45.1％、34.5％、35％화49.4％;량조비교,제LDL-C체표솔외,차이균유통계학의의(P＜0.05).량조년령、체질지수、고혈압、관심병、뇌혈관병、경동맥증후、경동맥반괴형성、경동맥협착、경동맥폐새차이균유통계학의의(균P＜0.05).경Logistic다원회귀분석사사LEAD위험인소유:년령、당뇨병사、뇌혈관병사、경동맥반괴형성、경동맥협착. 결론 LEAD환병솔37.2％,환자년령、당뇨병사、뇌혈관병사、경동맥반괴형성、경동맥협착위LEAD적위험인소,이전통동맥경화위험인소(고혈압、TC、LDL-C、흡연、비약물간예)시T2DM환자LEAD적위험인소.
Objective To make a cross-sectional assessment of the morbidity of lower extremity arterial disease (LEAD) in inpatients with type 2 diabetes mellitus (T2DM) and to analyze its risk factors,thus providing evidence for its clinical prevention.Methods We enrolled 664 inpatients with T2DM from June 2012 to June 2013 and collected clinical data,including age,gender,duration of diabetes,body mass index,smoking,fasting & postprandial blood glucose levels,glycosylated hemoglobin,serum lipids,renal function,fibrinogen,neck ultrasonography,lower extremity vascular ultrasound,ankle brachial index and treatment records.Logistic multiple regression analysis was conducted to identify risk factors for LEAD.Results A total of 247 cases met the diagnostic criteria for LEAD,with morbidity reaching to 37.2％.The percentages of morbidity in patients with different durations of diabetes were:23.12％ (≤ 5 years),27.95％ [(5 10) years],38.71％ [(1015) years],51.16％ [(15-20) years],62.34％ (≥ 20 years).The differences were statistically significant (P＜0.05).Of the patients in the LEAD group,73.2 ％ were treated with antihypertensive medications and 54.6％ were treated with statins.The goal attainment rates for total cholesterol,lowdensity lipoprotein cholesterol,high-density lipoprotein cholesterol and triglycerides were 56.3％,39.3％,47.4％ and 61.5％,respectively,in the LEAD group and 45.1％,34.5％,35％,and 49.4％,respectively,in the non-LEAD group.With the exception of the rates for low density lipoprotein cholesterol,the rates between the two groups are statistically significant (P＜0.05).Significant differences in age,BMI,blood pressure,coronary heart disease,cerebrovascular disease,carotid intima-media thickness,carotid artery plaque,and carotid artery stenosis were also observed between the two groups (P＜0.05 for all parameters).Logistic multiple regression analysis revealed that age,history of diabetes,cerebrovascular disease,carotid artery plaque,and carotid artery stenosis were risk factors for LEAD.Conclusions The morbidity of LEAD is 37.2％ in type 2 diabetic patients.Age,history of diabetes,cerebrovascular disease,carotid artery plaque,and carotid artery stenosis are risk factors for LEAD,while traditional risk factors for atherosclerosis,including hypertension,levels of cholesterol and low-density lipoprotein cholesterol,smoking,and non-drug intervention,are risk factors for LEAD in type 2 diabetic patients.