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目的探讨老年住院患者周围血管病变(PAD)的患病率,并分析其与代谢异常的关系。方法纳入60岁以上住院患者213例,通过电子血压计检测踝肱指数(ABI)进行分组:PAD组和非PAD对照组。所有患者检测空腹血糖(FBG)、血脂、C-反应蛋白(CRP)、尿酸(SUA)、同型半胱氨酸(HCY)、尿白蛋白排泄率(UAER)、空腹胰岛素(FIns)等,通过多元逐步回归分析探讨影响PAD的危险因素。结果 213例住院患者中PAD组35例(16.43%);非PAD对照组178例(83.54%)。PAD组年龄、舒张压与非PAD对照组比较差异无统计学意义(t值为0.47、1.53,P>0.05);腰围、收缩压(SBP)、FBG、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白(α)[Lp(α)]、载脂蛋白B100(APOB)、HCY、CRP、肌酐(Cr)、SUA、UAER、FIns、胰岛素抵抗指数(HOMA-IR)明显增高(t值分别为4.25、10.08、4.684、.334、.684、.144、.51、2.47、2.206、.29、4.01、3.48、12.09、8.85、15.63,P<0.01或P<0.05);高密度脂蛋白胆固醇(HDL-C)或脂蛋白A1(APOA1)明显低于非PAD对照组(t值为6.12、5.93,P<0.01)。多元逐步回归分析显示,HOMA-IR、UAER、SBP、Lp(a)是影响PAD的独立危险因素。结论 16.43%的老年住院患者存在PAD,电子血压计测量ABI简单、准确,可用于临床进行PAD患者的筛查。HOMA-IR、UAER、SBP、Lp(a)是加剧PAD的主要因素。
Objective To investigate the prevalence of peripheral vascular disease (PAD) in elderly inpatients and analyze its relationship with metabolic abnormalities. Methods A total of 213 hospitalized patients over the age of 60 were enrolled in this study. The ankle-brachial index (ABI) was measured by electronic sphygmomanometer. PAD group and non-PAD control group. Fasting blood glucose (FBG), lipids, C-reactive protein (CRP), uric acid (SUA), homocysteine (HCY), urinary albumin excretion rate (UAER) and fasting insulin (FIns) Multiple stepwise regression analysis to explore the risk factors affecting PAD. Results Among 213 inpatients, 35 were PAD (16.43%) and 178 (83.54%) were non-PAD. There was no significant difference in age, diastolic blood pressure between the PAD group and the non-PAD control group (t = 0.47,1.53, P> 0.05); waist circumference, systolic blood pressure (SBP), FBG, total cholesterol (TC), triglyceride TG, LDL-C, Lp α, APOB, HCY, CRP, Cr, SUA, UAER, FIns, insulin The resistance index (HOMA-IR) was significantly higher (t = 4.25,10.08,4.684, .334, .684, .144, .51,2.47,2.206, .29,4.01,3.48,12.09,8.85,15.63, P <0.01 or P <0.05). The levels of HDL-C or APOA1 were significantly lower than those in non-PAD control group (t = 6.12,5.93, P <0.01). Multiple stepwise regression analysis showed that HOMA-IR, UAER, SBP and Lp (a) were independent risk factors for PAD. Conclusion 16.43% of elderly hospitalized patients have PAD. The ABI measurement of electronic sphygmomanometer is simple and accurate, and can be used for clinical screening of PAD patients. HOMA-IR, UAER, SBP, Lp (a) are the main factors that aggravate PAD.