CAJ | 학술논문

目的：探讨2型糖尿病（DM）患者踝臂指数（ABI）、趾臂指数（TBI）的变化，及其与糖尿病足（DF）的相关性。方法回顾性分析2013年1月—2014年12月收治的126例2型DM患者的临床资料，其中并发DF 95例（ DF组），未并发DF 31例（ NDF组）。检测2组患者ABI、TBI水平的变化，采用多因素Logistic回归对DF的危险因素进行分析。结果 DF组与NDF组患者在2型DM病程、BMI、FPG、HbAlc、TC、TG、HDL-C、ABI、TBI等9个因素差异均有统计学意义（ P ＜0忖．05）；不同Wagner分级的DM患者ABI、TBI比较，差异均有统计学意义（ P ＜0．05），且随着Wagner分级的增加，ABI、TBI的异常率明显升高，数值明显降低（ P ＜0．05）。 Spearman秩相关性分析，ABI、TBI与Wagner分级均呈明显负相关（ r ＝－0．593、－0．604， P ＜0．05）；ABI、TBI联合检测，对DF的诊断敏感度（93．7％），明显高于ABI（69．5％）、TBI（67．4％）单独检测（ P ＜0．05）；多因素非条件Logistic回归分析，HDL-C、ABI、TBI均是DF的保护因素（ P ＜0．05），病程、HbA1c为危险因素（ P ＜0．05）。结论2型DM患者ABI、TBI明显降低，且与DF的发生及严重程度密切相关，ABI、TBI联合检测有助于提高DF的诊断敏感度。
목적：탐토2형당뇨병（DM）환자과비지수（ABI）、지비지수（TBI）적변화，급기여당뇨병족（DF）적상관성。방법회고성분석2013년1월—2014년12월수치적126례2형DM환자적림상자료，기중병발DF 95례（ DF조），미병발DF 31례（ NDF조）。검측2조환자ABI、TBI수평적변화，채용다인소Logistic회귀대DF적위험인소진행분석。결과 DF조여NDF조환자재2형DM병정、BMI、FPG、HbAlc、TC、TG、HDL-C、ABI、TBI등9개인소차이균유통계학의의（ P ＜0촌．05）；불동Wagner분급적DM환자ABI、TBI비교，차이균유통계학의의（ P ＜0．05），차수착Wagner분급적증가，ABI、TBI적이상솔명현승고，수치명현강저（ P ＜0．05）。 Spearman질상관성분석，ABI、TBI여Wagner분급균정명현부상관（ r ＝－0．593、－0．604， P ＜0．05）；ABI、TBI연합검측，대DF적진단민감도（93．7％），명현고우ABI（69．5％）、TBI（67．4％）단독검측（ P ＜0．05）；다인소비조건Logistic회귀분석，HDL-C、ABI、TBI균시DF적보호인소（ P ＜0．05），병정、HbA1c위위험인소（ P ＜0．05）。결론2형DM환자ABI、TBI명현강저，차여DF적발생급엄중정도밀절상관，ABI、TBI연합검측유조우제고DF적진단민감도。
Objective To investigate the changes of ankle brachial index ( ABI) and toe brachial index ( TBI) in patients with type 2 diabetes mellitus ( DM) and the correlation with diabetic foot ( DF) .Methods Retrospectively analyzed from January 2013 to December 2014 clinical data of 126 patients with type 2 DM, 95 cases among them ( group DF) were complicated with DF, and 31 cases ( group NDF) were not complicated with DF.ABI and TBI levels were detected in the 2 groups, and the risk factors of DF were analyzed by Logistic regression.Results Group DF and group NDF’ s type 2 DM, BMI, FPG and HbA1c, TC, TG, HDL-C, ABI and TBI showed statistically significant differences ( P <0.05); different Wagner classification of DM patients’ ABI and TBI showed statistically significant differences ( P <0.05), and along with the increase of Wagner classification, the abnormal rate of ABI and TBI were increased significantly, the number were signifi-cantly decreased ( P <0.05).Spearman rank correlation analysis showed that, ABI and TBI and Wagner classification had significant negative correlation ( r =-0.593, r =-0.604, P <0.05);ABI and TBI combined for detection, the sensitivity for diagnosis of DF (93.7%) was significantly higher than that of ABI (69.5%) and TBI (67.4%) along ( P <0.05);multi-factor non-conditional Logistic regression analysis showed that, HDL-C, ABI and TBI are DF protective factors ( P <0.05), duration of diabetes, HbA1c were the risk factors ( P <0.05).Conclusion It demonstrated that the TBI, ABI were significantly decreased in type 2 DM patients, and were closely related with the occurrence and severity of DF, the combina-tion ABI and TBI detection was helpful to improve the diagnostic sensitivity of DF.