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目的探讨糖尿病足(DF)发生情况与踝肱指数(ABI)的相关性及其影响因素,旨在为DF的早期防治提供临床诊断依据。方法选取门诊确诊的2型糖尿病(T2DM)患者168例为研究对象,根据患者是否出现DF将其分为DF组45例和非DF组123例,分别采用超声血流探测仪测定两组患者的ABI值,同时采用全自动生化分析仪测定患者甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA1c),比较两组患者上述指标的差异,分析ABI与上述各指标的相关性及影响DF的危险因素。结果与非DF组相比,DF组患者病程、HbA1c、LDL-C、收缩压、Hs-CRP水平及糖尿病肾病发生率、糖尿病视网膜疾病发生率显著升高,而HDL-C及ABI值则显著降低(P均<0.01)。单因素相关分析表明,ABI与患者病程、HbA1c、收缩压、糖尿病肾病发生率、糖尿病视网膜病变发生率呈负相关。经Logistic多因素回归分析可知,ABI、病程、HbA1c是DF发生的独立危险因素。结论 ABI与DF的发生具有密切关系,可作为DF诊断的预测指标,对于ABI异常的T2DM患者应加强干预,防止DF的发生。
Objective To investigate the relationship between the incidence of diabetic foot (DF) and the ankle-brachial index (ABI) and its influencing factors in order to provide a basis for the clinical diagnosis of DF. Methods A total of 168 outpatients with type 2 diabetes mellitus (T2DM) were enrolled in this study. According to their DF, they were divided into DF group (n = 45) and non-DF group (n = 123) ABI values were measured at the same time. The levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin HbA1c). The differences between the above two groups of patients were compared. The correlation between ABI and the above indexes and the risk factors of DF were analyzed. Results Compared with non-DF group, the course of disease, the levels of HbA1c, LDL-C, systolic blood pressure, Hs-CRP and the incidence of diabetic nephropathy and diabetic retinopathy in DF group were significantly increased, while the HDL-C and ABI values were significantly Decreased (P <0.01). Univariate analysis showed that ABI was negatively correlated with the duration of the disease, HbA1c, systolic blood pressure, incidence of diabetic nephropathy and the incidence of diabetic retinopathy. Logistic multivariate regression analysis shows that ABI, duration of disease, HbA1c is an independent risk factor for DF. Conclusion ABI is closely related to the occurrence of DF and can be used as a predictor of DF diagnosis. For patients with abnormal ABI, T2DM should be strengthened to prevent the occurrence of DF.