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目的:探讨踝肱指数(ABI)用于预测糖尿病下肢血管病变(PAD)发生情况,并探讨其相关危险因素,以便达到早期诊断治疗。方法:对我院收治的120例糖尿病患者进行踝肱指数(ABI)的测量,并抽血检查HbAlC、TC、TG、HDL-C、LDL-C等生理生化指标,与彩色多普勒超声检查结果进行对比,并对其危险因素进行COX回归分析。结果:临床症状评分方面,重度组与无症状、中度、轻度症状组比较,差异有统计学意义(P<0.05);ABI取值为0.9时,其灵敏度为76.56%、特异性96.43%,阳性预测值96.08%、阴性预测值78.26%、诊断符合率为85.83%;COX回归分析显示,高龄、病程长、吸烟、高血压史、冠心病史、高血脂、脑卒中、糖尿病肾病、糖尿病视网膜病、HbAlC、LDL-C为PAD的危险因素。结论:ABI检测是临床上一种简单可行的早期诊断糖尿病下肢血管病变的方法之一,诊断符合率高,但同时其受到年龄、病程、吸烟、高血压、冠心病、高血脂、脑卒中、糖尿病肾病、糖尿病视网膜病、HbAlC、LDL-C等相关因素的影响。
Objective: To investigate the ankle-brachial index (ABI) used to predict the occurrence of diabetic lower extremity vascular disease (PAD), and explore the related risk factors in order to achieve early diagnosis and treatment. Methods: Ankle-brachial index (ABI) was measured in 120 diabetic patients admitted to our hospital. Blood samples were taken for HbA1c, TC, TG, HDL-C, LDL-C and other physiological and biochemical parameters. Color Doppler ultrasonography The results were compared and the risk factors for COX regression analysis. Results: In clinical symptom score, the difference was statistically significant between severe group and asymptomatic, moderate and mild symptom group (P <0.05). When the ABI value was 0.9, the sensitivity and specificity were 76.56% and 96.43% , The positive predictive value was 96.08%, the negative predictive value was 78.26%, and the diagnostic coincidence rate was 85.83%. The COX regression analysis showed that old age, long duration of disease, history of smoking, history of hypertension, history of coronary heart disease, hyperlipemia, stroke, diabetic nephropathy, Retinopathy, HbAlC, LDL-C are risk factors for PAD. Conclusion: ABI is one of the simple and feasible methods for early diagnosis of diabetic lower extremity vascular disease. The diagnostic accuracy is high, but at the same time it is affected by age, duration, smoking, hypertension, coronary heart disease, hyperlipemia, stroke, Diabetic nephropathy, diabetic retinopathy, HbAlC, LDL-C and other related factors.