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目的:应用血管超声评价并比较不同踝肱指数(ABI)值糖尿病患者下肢动脉粥样硬化斑块形成的情况。方法:测量140例共280支糖尿病患者下肢动脉的ABI。根据ABI值将患者分为3组:正常ABI组(179支血管,0.9≤ABI≤1.3)、低ABI组(71支血管,ABI<0.9)、高ABI组(30支血管,ABI>1.3)。应用血管超声评价下肢动脉粥样硬化斑块形成情况,计算和比较各组下肢动脉有斑块与无斑块的百分比。结果:正常ABI组下肢动脉中有斑块与无斑块的分别为92支(51.4%)与87支(48.6%),低ABI组下肢动脉中有斑块和无斑块的分别为70支(98.6%)与1支(1.4%),高ABI组下肢动脉中有斑块和无斑块的分别为12支(40.0%)与18支(60.0%)。正常ABI组和高ABI组下肢动脉的斑块率比较,差异无统计学意义(P=0.338),但均明显低于低ABI组(P<0.05)。结论:在ABI正常和增高的糖尿病患者中下肢动脉存在粥样硬化斑块的比例也较高,评价下肢动脉病变应将ABI与血管超声相结合。
OBJECTIVE: To evaluate and compare the formation of atherosclerotic plaque of lower extremities in diabetic patients with different ankle brachial index (ABI). Methods: The ABI of lower extremity arteries in 140 patients with 280 diabetic patients was measured. According to ABI, patients were divided into three groups: normal ABI group (179 blood vessels, 0.9≤ABI≤1.3), low ABI group (71 blood vessels, ABI <0.9), high ABI group (30 blood vessels, ABI> 1.3) . Vascular ultrasonography was used to evaluate the formation of atherosclerotic plaque in lower extremities. The percentage of lower extremity arterial plaque and no plaque in each group was calculated and compared. Results: There were 92 (51.4%) and 87 (48.6%) of the lower extremity arteries in the normal ABI group, respectively. In the low ABI group, there were 70 plaques and no plaque in the lower extremity arteries (98.6%) and 1 (1.4%) in the upper ABI group, respectively. There were 12 (40.0%) and 18 (60.0%) plaques in the ABI group. There was no significant difference in the plaque rate between the normal ABI group and the high ABI group (P = 0.338), but both were significantly lower than those in the low ABI group (P <0.05). Conclusion: There is a high proportion of atherosclerotic plaque in lower extremity arteries in patients with normal and elevated ABI. ABI should be combined with ultrasonography in evaluating lower extremity arterial disease.