论文部分内容阅读
目的分析糖尿病足病患者下肢动脉粥样硬化病变与代谢异常的关系。方法选择2型糖尿病患者362例,男性232例,女性130例,平均年龄(64.9±11.2)岁,平均糖尿病病程(9.2±7.5)年。通过动脉超声检查下肢股动脉、腘动脉和胫动脉病变情况,按照动脉病变程度将患者分为4组:对照组、斑块组、狭窄组(≥50%)和闭塞组。所有患者测定空腹血糖、糖化血红蛋白(GhbAlc)和血脂谱(总胆固醇、甘油三酯、低密度脂蛋白和高密度脂蛋白)等。结果 (1)斑块组和狭窄组患者GHbAlc 水平分别为(8.4±2.2)%和(8.7±2.1)%,与对照组(7.9+2.1)%比较,差异有统计学意义(P<0.05),狭窄组胆固醇和甘油三酯水平均比斑块组高(P<0.05和 P<0.01);(2)斑块组和狭窄组患者高血压、冠心病、眼底病变以及肾脏病变患病率显著高于对照组和闭塞组(P<0.05);(3)股动脉和腘动脉斑块病变患病率为77.8%和73.3%,高于胫动脉62.1%(P<0.01)。狭窄和闭塞病变主要发生在胫动脉,分别为29.1%和6.1%。结论中老年糖尿病患者股动脉、腘动脉和胫动脉斑块病变较常见,且动脉病变与代谢异常相关,应给予积极的干预治疗。
Objective To analyze the relationship between lower extremity atherosclerosis and metabolic abnormalities in diabetic foot disease. Methods 362 patients with type 2 diabetes mellitus were selected, including 232 males and 130 females, with an average age of 64.9 ± 11.2 years and an average duration of diabetes of 9.2 ± 7.5 years. The lesions of the femoral, popliteal and tibiofemoral arteries in lower extremities were examined by arterial ultrasonography. The patients were divided into 4 groups according to the degree of arterial disease: control group, plaque group, stenosis group (≥50%) and occlusion group. Fasting blood glucose, glycosylated hemoglobin (GhbAlc) and lipid profiles (total cholesterol, triglycerides, low density lipoproteins and high density lipoproteins) were measured in all patients. Results The levels of GHbA1c in the plaque group and the stenosis group were (8.4 ± 2.2)% and (8.7 ± 2.1)%, respectively, which were significantly different from those in the control group (7.9 ± 2.1)% (P <0.05) (P <0.05 and P <0.01). (2) The prevalence of hypertension, coronary heart disease, retinopathy and nephropathy in the plaque group and the stenosis group were significantly higher than those in the plaque group (P <0.05). (3) The prevalence of plaque lesions in femoral and popliteal artery was 77.8% and 73.3%, respectively, which was higher than 62.1% in tibiofemoral artery (P <0.01). Stenosed and occluded lesions occurred mainly in the tibial arteries, at 29.1% and 6.1%, respectively. Conclusion Middle-aged and elderly diabetic patients with common femoral artery, popliteal artery and tibia artery plaque lesions, and arterial disease and metabolic abnormalities should be given a positive intervention.