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目的了解上海社区糖尿病及糖调节受损(IGR)人群周围血管病变(PVD)的患病率及其主要危险因素。方法对2000—2001年间上海市曹杨社区代谢综合征流行病学调查获得的糖尿病及IGR患者(717例)进行5年后的随访,将其中完成随访并具有完整数据者427例纳入本次分析,其中男性210例,女性217例,年龄21~104岁(67·3岁±14·0岁)。PVD采用NicoletVersalabSE双向多普勒血流探测仪检测踝/肱动脉压比值(A/BI)进行诊断,同时采用爱丁堡跛行问卷调查间歇性跛行。对与PVD有关的各影响因素进行Logistic回归分析。结果曹杨社区高血糖人群PVD患病率为12·2%,其中在糖尿病人群中为15·1%,在IGR人群中为7·7%。在ABI≤0·9患者中仅13·5%出现间歇性跛行症状。Logistic回归分析发现,年龄、性别、糖尿病病程及总胆固醇是糖尿病周围血管病变的独立危险因素。结论上海社区高血糖人群中PVD患病率较高,不仅发生于糖尿病阶段,而且在糖尿病前期即已出现。大多数PVD患者无临床症状,因此在糖尿病门诊常规进行多普勒ABI检测有助于PVD的早期诊断、早期干预。
Objective To investigate the prevalence and major risk factors of peripheral vascular disease (PVD) in people with diabetes mellitus and impaired glucose regulation (IGR) in Shanghai community. Methods Diabetic and IGR patients (717 cases) obtained from epidemiological survey of metabolic syndrome in Shanghai community were surveyed after 5 years from 2000 to 2001. A total of 427 patients with follow-up and complete data were included in this analysis. There were 210 males and 217 females, ranging in age from 21 to 104 years (67.3 years ± 14.0 years). PVD Nicolet VersalabSE bi-directional Doppler flow detector for detecting ankle / brachial artery pressure ratio (A / BI) for diagnosis, while the use of the Edinburgh claudication survey of intermittent claudication. Logistic regression analysis was performed on the various factors related to PVD. Results The prevalence of PVD in the hyperglycemic population of Caoyang community was 12.2%, which was 15.1% in diabetic population and 7.7% in IGR population. In only 13.5% of patients with ABI ≤0.9 symptoms of intermittent claudication. Logistic regression analysis found that age, gender, duration of diabetes and total cholesterol were independent risk factors for peripheral vascular disease in diabetic patients. Conclusion The prevalence of PVD in the hyperglycemic population in Shanghai community is high, not only in the stage of diabetes mellitus but also in the pre-diabetes stage. Most PVD patients have no clinical symptoms, so routine Doppler ABI testing in diabetes clinic can help early diagnosis and early intervention of PVD.