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目的探讨2型糖尿病患者踝肱指数(ABI)与糖尿病肾病患者肾功能的关系。方法选择2型糖尿病患者416例,根据ABI分为ABI异常组(ABI<0.9或≥1.3)93例,ABI正常组323例。对比分析两组临床资料,二分类Logistic回归分析ABI异常的危险因素;根据估算肾小球滤过率(e GFR)对慢性肾脏病(CKD)进行分期,比较不同分期患者ABI异常发生率。结果 ABI异常组年龄、病程、血肌酐、尿素氮、尿酸、尿白蛋白肌酐比及高血压、糖尿病肾病、糖尿病周围神经病、糖尿病视网膜病变、糖尿病足发生率高于ABI正常组(P均<0.05),e GFR、甘油三酯水平低于ABI正常组(P均<0.05)。年龄、低e GFR、糖尿病肾病、糖尿病视网膜病变、糖尿病足是ABI异常的独立危险因素(OR分别为1.072、0.978、1.991、2.323、12.018,P均<0.05)。ABI异常发生率随CKD肾功能下降呈进行性升高(P<0.05)。结论 ABI异常与2型糖尿病肾病有关,ABI异常的2型糖尿病肾病患者肾功能多下降。
Objective To investigate the relationship between ankle-brachial index (ABI) and renal function in patients with type 2 diabetes mellitus (T2DM). Methods 416 patients with type 2 diabetes mellitus were selected and divided into three groups according to ABI: ABI <0.9 or ≥1.3, and ABI normal group, 323 cases. The clinical data of two groups were compared. Logistic regression analysis was used to analyze the risk factors of ABI abnormalities. Chronic kidney disease (CKD) was staged according to the estimated glomerular filtration rate (eGFR), and the ABI abnormalities were compared among different stages. Results The age, course of disease, serum creatinine, urea nitrogen, uric acid, urinary albumin creatinine ratio and the incidence of hypertension, diabetic nephropathy, diabetic peripheral neuropathy, diabetic retinopathy and diabetic foot in ABI group were significantly higher than those in normal ABI group (all P <0.05 ), eGFR, triglyceride levels were lower than those in normal ABI group (all P <0.05). Age, low eGFR, diabetic nephropathy, diabetic retinopathy and diabetic foot were the independent risk factors for ABI abnormalities (OR = 1.072,0.978,1.991,2.323,12.018, P <0.05 respectively). Abnormal incidence of ABI decreased with CKD decreased renal function (P <0.05). Conclusions Abnormal ABI is associated with type 2 diabetic nephropathy. Patients with type 2 diabetic nephropathy with abnormal ABI have more renal function.