摘要
目的初步探讨糖尿病下肢动脉中膜钙化发生发展的影响因素。方法选择在中山大学孙逸仙纪念医院内分泌科住院患者、门诊患者共400例。记录患者一般临床资料、体格检查结果、实验室检查结果。彩色多普勒超声检测双侧股浅动脉、胫前动脉、胫后动脉、足背动脉,将下肢动脉中膜钙化严重程度按照0~8分予以评估,以(1~4分)为轻度,(5~8分)为重度。结果彩色多普勒超声检查中糖尿病组下肢动脉中膜钙化检出率高(60.9%vs 25.2%,P<0.001),重度中膜钙化检出率也高。糖尿病患者中,增龄(r=0.36,β=0.1;OR,1.10;95%CI,1.07~1.13,P<0.001)、低高密度脂蛋白胆固醇血症(r=-0.13,β=-1.08;OR,0.38;95%CI,0.16~0.91,P<0.05)与下肢动脉中膜钙化发生相关;高收缩压(r=0.14,β=0.02;OR,1.02;95%CI,0.99~1.04,P<0.05)与下肢动脉重度中膜钙化发生相关。结论 2型糖尿病为下肢动脉中膜钙化独立危险因素。增龄、高收缩压、低高密度脂蛋白胆固醇血症等影响因素可能参与了糖尿病患者下肢动脉中膜钙化发生以及钙化严重程度向重度中膜钙化发展。
Objective To detect the severity of lower extremity arterial MAC in type 2 diabetic patients through ultrasonography. Methods 400 Chinese patients aged 30-80 were enrolled from endocrinology department or out-patient clinic of Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University. All patients underwent clinical evaluations and blood samples were obtained. Ultrasonography was performed in detection of superficial femoral arteries,anterior tibial arteries,posterior tibial arteries,and dorsalis pedis arteries. A score from 0 to 8 was assigned to evaluate the severity of MAC,and different degrees were recorded from mild（ scores 1 ~ 4） to severe（ scores 5 ~ 8）. Results Ultrasonography results showed that the incidence of MAC was higher in type 2 diabetes（ 60. 9% vs 25. 2%,P〈0. 001）. In type 2 diabetes,the severity of MAC was also higher,and the incidence of MAC was higher in below-knee arteries compared with that of the above-knee arteries. Aging（ correlation coefficient（ r） = 0. 36,regression coefficient（ β） = 0. 1; OR,1. 10; 95% CI,1. 07 ~ 1. 13,P〈0. 001）,low high density lipoprotein cholesterol（ r =-0. 13,β =-1. 08; OR,0. 38; 95% CI,0. 16 ~ 0. 91,P〈0. 05）seemed to be related to the presence of MAC. High systolic blood pressure（ r = 0. 14,β = 0. 02; OR,1. 02; 95% CI,0. 99 ~1. 04,P〈0. 05） seemed to be related to the severe degrees of MAC. Conclusion In patients of type 2 diabetes,the incidence and severity of lower extremity MAC were higher than that of non-diabetic patients. Type 2 diabetes was a major risk factor for lower extremity MAC. The incidence of MAC may also related with aging,low high density lipoprotein cholesterol,high systolic blood pressure. Other risk factors of MAC and MAC＇s relationship with diabetic complications need to be further investigated.
作者
劳钰
罗葆明
杨川
任萌
刘丹
田晶
阮镜良
严励
LAO Yu;LUO Baoming;YANG Chuan;REN Meng;LIU Dan;TIAN Jing;RUAN Jingliang;YAN Li(Guangdong Second People＇s Hospital,Guangzhou 510317,China)
出处
《现代医院》
2018年第8期1168-1173,共6页
Modern Hospitals
基金
广东省医学科学技术研究基金(B2018024)
关键词
糖尿病
外周动脉疾病
血管钙化
超声检查
危险因素
Diabetes Mellitus
Peripheral Arterial Disease
Vascular Calcification
Ultrasonography
Risk Factors
