老年稳定性心绞痛合并2型糖尿病患者踝肱指数异常的临床研究

摘要

目的 研究老年稳定性心绞痛(SAP)合并T2DM患者踝肱指数(ABI)异常情况及临床意义. 方法 选择SAP合并T2DM(SAP+ T2DM组)老年患者50例,SAP(SAP组)老年患者48例,T2DM(T2DM组)老年患者35例,测定ABI、高敏C反应蛋白(hsC-RP)、髓过氧化物酶(MPO)水平和血管内皮功能. 结果 SAP+ T2DM组ABI值与SAP、T2DM组比较差异有统计学意义[(0.46±0.19)vs(0.96±0.17) vs(0.97±0.12),P＜0.05]; SAP+TT2DM组与SAP、T2DM组MPO、hsC-RP水平比较差异有统计学意义[(274.3±91.4) vs (109.7±28.7)vs (107.4±18.6)mmol/L; (7.93±2.8)vs (1.53±0.5) vs (1.18±0.6) mg/L,P＜0.05]; SAP+T2DM组与SAP、T2DM组肱动脉内皮依赖性舒张功能比较差异有统计学意义[(3.89±2.99)％vs (7.85±1.94)％ vs (7.90±4.36)％,P＜0.05]. 结论 ABI降低对评价动脉功能损害及识别高危患者有重要的临床意义.%Objective To investigate the abnormity and the clinical implications of ankle brachial index (ABI) in elderly patients complicated with stable angina pectoris and type 2 diabetes mellitus.Methods Fifty patients with stable angina pectoris and type 2 diabetes mellitus (SAP+T2DM group),48 patients with stable angina pectoris (SAP group),and 35 patients with type 2 diabetes mellitus (T2DM group) were recruited for this study.ABI and endothelial dependent flow-mediated dilation (FMD) in the brachial artery were evaluated.The levels of high sensitive C-reactive protein (hsC-RP) and myeloperoxidase (MPO) were also assessed.Results ABI was significantly lower in the SAP+T2DM group than in the SAP or T2DM groups [(0.46±0.19) vs (0.96±0.17) vs (0.97±0.12),P＜0.05].The levels of MPO and.hsC-RP were significantly higher in the SAP+T2DM group than in the SAP or T2DM groups [(274.3±91.4) vs (109.7±28.7) vs (107.4±18.6) mmol/L; (7.93±2.8) vs (1.53±0.5) vs (1.18±0.6) mg/L,P＜0.05]; and FMD in the brachial artery was significantly lower in the SAP +T2DM group than in the SAP or T2DM groups [(3.89±2.99)％ vs (7.85±1.94)％ vs (7.90±4.36)％,P＜0.05].Conclusion The lowered ABI is of great importance to evaluate the damage of arterial function and identify the high-risk patients.