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目的探讨踝肱动脉血压指数(ABI)在诊断2型糖尿病(T2DM)下肢动脉病变(PAD)的意义及临床影响因素。方法采用多普勒超声血流仪对107例糖尿病患者进行ABI检测,按照ABI值分为两组,ABI<0.9为PAD组,ABI≥0.9为非PAD组,比较分析两组临床资料,采用多元(logistic回归分析)方法分析ABI异常患者的临床相关因素。结果 PAD组与非PAD组比较,年龄、病程、收缩压、脉压差、餐后血糖、糖化血红蛋白(HbA1C)、尿酸、吸烟率以及合并溃疡率差异均有统计学意义。多元回归分析显示:年龄、病程、HbA1C、餐后血糖、高TG、收缩压是影响2型糖尿病患者下肢动脉病变的独立因素。结论 ABI检测是临床方便、无创的诊断下肢动脉病变的指标。年龄、病程、高TG、血糖及血压控制差是2型糖尿病患者下肢动脉病变的主要因素。
Objective To investigate the significance and clinical influential factors of ankle brachial artery blood pressure index (ABI) in the diagnosis of lower extremity arterial disease (PAD) in type 2 diabetes mellitus (T2DM). Methods A total of 107 patients with diabetes mellitus underwent ABI examination by Doppler ultrasonography. The patients were divided into two groups according to the ABI value. The patients with ABI <0.9 were in the PAD group and ABI≥0.9 in the non-PAD group. The clinical data of both groups were compared and analyzed. (logistic regression analysis) method to analyze the clinically relevant factors in patients with ABI abnormalities. Results There were significant differences in age, course of disease, systolic blood pressure, pulse pressure, postprandial blood glucose, HbA1C, uric acid, smoking rate and combined ulcer rate between PAD group and non-PAD group. Multivariate regression analysis showed that age, duration of disease, HbA1C, postprandial blood glucose, high TG, and systolic blood pressure were the independent factors affecting lower extremity arterial disease in type 2 diabetic patients. Conclusion ABI detection is clinically convenient and non-invasive diagnosis of arterial disease in lower extremity. Age, duration, high TG, poor blood glucose and blood pressure control in patients with type 2 diabetes lower extremity arterial disease is the main factor.