糖尿病患者下肢动脉病变及相关危险因素探讨

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目的 采用彩色多普勒超声诊断仪 (CDFI)来探讨糖尿病患者下肢动脉病变及相关危险因素。方法 对 15 0例糖尿病患者 ,4 8例正常对照组 ,进行 CDFI下肢动脉检查 ,观察血管内径、流速、流量、阻力指数及搏动指数 ,并给予空腹血糖、糖化血红蛋白、血脂等生化检查。结果 糖尿病组下肢动脉病变 10 8例 (72 .0 % )较对照组下肢动脉硬化病变发生率明显增高 (P<0 .0 1) ,单支血管病变发生率占检出者 4 6 .3% ,双支以上血管病变发生率占检出者 4 4 .4 % ,糖尿病病程大于 5年以上患者下肢血管病变发生率占检出者 79.6 % ,斑块检出率占检出者 80 .5 % ,糖尿病组流速、血管内径、血流量较对照组明显减少 (P<0 .0 1) ,下肢动脉病变与高血压、冠心病、周围神经病变、空腹血糖、糖化血红蛋白、甘油三脂及总胆固醇 /高密度脂蛋白比值呈正相关。结论 糖尿病患者下肢动脉有明显损伤、动脉硬化发生率高。彩色多普勒超声早期诊断下肢动脉病变准确、可信有重要临床价值 ,糖脂代谢紊乱高血压、冠心病等是糖尿病下肢动脉病变的危险因素。 Objective To investigate the lower extremity arterial disease and related risk factors in diabetic patients by color Doppler sonography (CDFI). Methods 150 cases of diabetic patients and 48 normal controls were examined by CDFI. The diameter, flow velocity, flow rate, resistance index and pulsatility index were observed. Fasting blood glucose, glycosylated hemoglobin and lipids were also examined. Results The lower extremity arterial disease in diabetic group was significantly higher than that in control group (P <0.01), and the incidence of unilateral bronchial lesions was 46.3% in 108 cases (72.0%) of control group. , The incidence of double-vessel vascular disease accounted for 44.4% of the detected, the duration of diabetes more than 5 years in patients with lower extremity vascular lesions accounted for the detection of 79.6%, plaque detection rate accounted for 80.5% (P <0.01), lower extremity arterial disease and hypertension, coronary heart disease, peripheral neuropathy, fasting blood glucose, glycosylated hemoglobin, triglycerides and total cholesterol / High density lipoprotein ratio was positively correlated. Conclusion The lower extremity arteries of diabetic patients have obvious injury and the incidence of atherosclerosis is high. Color Doppler ultrasound early diagnosis of lower extremity arterial lesions is accurate, credible has important clinical value, disorders of glucose and lipid metabolism, coronary heart disease and other risk factors for diabetic lower extremity arterial disease.
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