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目的了解尚未达到周围血管病变(PAD)诊断标准的糖尿病患者大血管病变的发生情况。方法踝肱指数(ABI)>0.9的住院T2DM患者601例,根据血管彩超结果分为无病变组和有病变组,另根据病变部位将有病变组分为下肢血管病变亚组、颈部血管病变亚组及多部位病变亚组进行比较分析。结果 64.2%(386/601)的患者存在不同程度的大血管病变,其中单纯下肢动脉病变者44.6%(172/386),单纯颈动脉病变者13.5%(52/386),多部位病变者41.9%(162/386)。与无病变组相比,有病变组TG、FIns、2hIns水平均较低,糖尿病性慢性肾脏疾病(CKD)及冠心病(CAD)的患病率较高,比较差异有统计学意义(P<0.05)。Logistic回归分析显示,CKD是血管病变发生的独立危险因素。结论在依据ABI诊断下肢动脉粥样硬化之前,血管彩超显示已有64.2%的糖尿病患者存在不同程度的大血管病变。
Objective To understand the incidence of macrovascular disease in diabetic patients who have not yet reached the diagnostic criteria of peripheral vascular disease (PAD). Methods One hundred and sixty-two inpatients with T2DM with ankle-brachial index (ABI)> 0.9 were divided into non-lesion group and diseased group according to the result of vascular ultrasound. According to the lesion site, lesion group was divided into subgroup of lower extremity vascular disease, Subgroups and multi-site disease subgroups for comparative analysis. Results 64.2% (386/601) of the patients had varying degrees of macroangiopathy. Among them, 44.6% (172/386) of simple lower extremity arterial lesions, 13.5% (52/386) of simple carotid artery lesions, 41.9 % (162/386). Compared with the non-lesion group, the levels of TG, FIns and 2hIns in the diseased group were lower, the prevalence of CKD and CAD were higher, the difference was statistically significant (P < 0.05). Logistic regression analysis showed that CKD was an independent risk factor for vascular disease. Conclusion Before the diagnosis of atherosclerosis of the lower extremities according to ABI, vascular colorimetry showed that 64.2% of diabetic patients had different degree of macrovascular disease.