2型糖尿病下肢血管病變的危險(xiǎn)因素分析

于占妹

摘要：目的 ?了解2型糖尿病下肢動(dòng)脈病變病例特點(diǎn)及危險(xiǎn)因素。方法 ?收集2018年1月～2019年12月天津市寧河區(qū)某醫(yī)院體檢的150例糖尿病患者的體檢資料，依據(jù)踝/肱動(dòng)脈比值（ABI）將患者分為糖尿病下肢血管病變（DLEV組）和糖尿病非下肢血管病變（非DLEV組），分析兩組一般資料情況，并采用多因素Logsitic分析糖尿病下肢動(dòng)脈病變的影響因素。結(jié)果 ?共150例糖尿病患者，其中存在糖尿病下肢血管病變者35例。兩組年齡、性別、血脂水平比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）;兩組病程、BMI、吸煙史、飲酒史、空腹血糖、糖化血紅蛋白、血壓、蛋白尿比較，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;多因素Logistic分析顯示，病程、空腹血糖、血壓水平、蛋白尿等是糖尿病足下肢動(dòng)脈病變的危險(xiǎn)因素。結(jié)論 ?糖尿病足下肢血管病變患者多糖尿病病程較長(zhǎng)，空腹血糖、血壓控制不佳，多兼有蛋白尿等情況。臨床中應(yīng)對(duì)以上因素予以重視，以控制和改善糖尿病下肢血管病變的發(fā)生、發(fā)展。

關(guān)鍵詞：2型糖尿病;下肢血管病變;蛋白尿

中圖分類號(hào)：R587.1 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 文獻(xiàn)標(biāo)識(shí)碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? DOI：10.3969/j.issn.1006-1959.2020.18.033

文章編號(hào)：1006-1959（2020）18-0101-03

Risk Factors of Lower Extremity Vascular Disease in Type 2 Diabetes Mellitus

YU Zhan-mei

（Department of Medicine，Ninghe Hospital，Ninghe District，Tianjin 301500，China）

Abstract：Objective ?To understand the characteristics and risk factors of lower extremity arterial disease in type 2 diabetes.Methods ?The physical examination data of 150 diabetic patients who were examined in a hospital in Ninghe District， Tianjin from January 2018 to December 2019 were collected， and the patients were divided into diabetic lower extremity vascular disease （DLEV group） and based on the ankle/brachial artery ratio （ABI）. Diabetic non-lower extremity vascular disease （non-DLEV group）， analyze the general data of the two groups， and use multivariate Logsitic to analyze the influencing factors of diabetic lower extremity arterial disease.Results ?A total of 150 patients with diabetes， including 35 patients with diabetic lower limb vascular disease. There was no statistically significant difference between the two groups in age， gender， and blood lipid levels （P>0.05）; the two groups had statistically significant differences in the course of disease， BMI， smoking history， drinking history， fasting blood glucose， glycosylated hemoglobin， blood pressure， and proteinuria （P<0.05）; Multivariate Logistic analysis showed that the course of disease， fasting blood glucose， blood pressure level， proteinuria， etc. were risk factors for diabetic lower extremity arterial disease.Conclusion ?Diabetic patients with vascular disease of the lower extremities had a longer course of diabetes， poor control of fasting blood sugar and blood pressure， and often had proteinuria.Attention should be paid to the above factors in clinical practice to control and improve the occurrence and development of diabetic lower limb vascular disease.

Key words：Type 2 diabetes;Lower extremity vascular disease;Proteinuria

隨著人們生活方式的改善和人口老齡化的發(fā)展，糖尿病的患病率逐年增長(zhǎng)。糖尿病影響全身多個(gè)器官和系統(tǒng)，對(duì)血管的影響尤為明顯，而糖尿病周圍血管病變是指除外心腦血管、腎血管、視網(wǎng)膜血管之外的肢體大動(dòng)脈和中小動(dòng)脈的粥樣硬化和微血管病變。有研究表明[1]，糖尿病患者周圍血管病變的發(fā)生率接近50%，而下肢血管病變是較早發(fā)生血管病變的部位，糖尿病下肢血管病變也是截肢和導(dǎo)致患者死亡的重要因素，據(jù)報(bào)道[2]，糖尿病患者截肢后5年死亡率接近50%。因此，較早認(rèn)識(shí)糖尿病并發(fā)癥的危險(xiǎn)因素，對(duì)于早期診斷、早期治療，預(yù)防和避免各種糖尿病并發(fā)癥的發(fā)生和發(fā)展具有重要意義。本研究結(jié)合2018年1月～2019年12月天津市寧河區(qū)某醫(yī)院針對(duì)門診就診的150糖尿病患者的體檢資料，了解糖尿病下肢血管病變的危險(xiǎn)因素，現(xiàn)報(bào)道如下。