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目的了解踝肱指数(ankle-brachial index,ABI)对诊断糖尿病下肢动脉病变的意义及其相关因素分析。方法对2007年5月-10月156例2型糖尿病患者测定ABI,根据ABI分为3组:低ABI组(ABI<0.9)、高ABI组(ABI>1.3)、正常组(0.9≤ABI≤1.3),测量身高、体重、血压、血糖、糖化血红蛋白、血脂、尿微量白蛋白水平。结果156例糖尿病患者中低ABI组37例,高ABI组16例,正常组103例。低ABI组的年龄、糖尿病病程、高血压病程、舒张压均高于正常组(P<0.05);高ABI组的年龄、糖尿病病程、高血压病程、收缩压、脉压、TG均高于正常组(P<0.05);两异常组的HDL-C均较正常组降低(P<0.05)。高ABI组的脉压高于低ABI组,高ABI组的舒张压低于低ABI组(P<0.05)。行双下肢血管彩色多普勒超声检查,低ABI组、高ABI组及ABI正常组出现血管异常者分别为29例(78.38%)、13例(81.25%)和12例(11.65%)。结论年龄、病程、血压、血脂是影响ABI的关键因素,高ABI患者和低ABI患者临床表现各有特点。
Objective To investigate the significance of ankle-brachial index (ABI) in the diagnosis of diabetic lower extremity arterial disease and its related factors. Methods 156 patients with type 2 diabetes mellitus (ABI) were divided into three groups according to ABI: low ABI group (ABI <0.9), high ABI group (ABI> 1.3), normal group (0.9≤ABI≤ 1.3), height, weight, blood pressure, blood glucose, glycosylated hemoglobin, blood lipids, urine microalbumin levels. Results Among 156 patients with diabetes, there were 37 cases of low-ABI group, 16 cases of high ABI group and 103 cases of normal group. The age, diabetes course, duration of hypertension and diastolic blood pressure in the low ABI group were higher than those in the normal group (P <0.05). The age, diabetes duration, duration of hypertension, systolic blood pressure, pulse pressure and TG in the high ABI group were all higher than those in the normal Group (P <0.05). HDL-C in two abnormal groups was lower than that in normal group (P <0.05). The pulse pressure in the high ABI group was higher than that in the low ABI group, and the diastolic pressure in the high ABI group was lower than that in the low ABI group (P <0.05). Color Doppler echocardiography was performed in both lower extremity vessels. There were 29 (78.38%), 13 (81.25%) and 12 (11.65%) patients with vascular abnormalities in low ABI group, high ABI group and normal ABI group. Conclusion Age, duration of disease, blood pressure and blood lipids are the key factors affecting ABI. The clinical manifestations of patients with high ABI and low ABI have their own characteristics.