住院2型糖尿病患者颈动脉及下肢动脉血管斑块检出率及危险因素分析

摘要

目的 了解我院住院2型糖尿病患者颈动脉及下肢动脉血管斑块检出率,分析与斑块相关的临床因素及生化指标、危险因素.方法 收集2015年6月至2017年2月在我院住院2型糖尿病患者482例病历资料,根据颈动脉及下肢动脉血管彩超结果,分为无斑块组(A组)、单纯颈动脉或下肢动脉斑块组(B组)、颈动脉和下肢动脉复合斑块组(C组).结果 总检出率86.10%,其中,单纯颈动脉斑块17例(3.5%),单纯下肢动脉斑块77例(15.98%),复合斑块321例(66.60%).复合斑块组与无斑块组比较,年龄更大、病程更长、餐后2h血糖(PPG)、低密度脂蛋白胆固醇(LDL-C)更高,高密度脂蛋白胆固醇(HDL-C)低,差异有统计学意义(P<0.05);合并高血压病、脑卒中、冠心病比例高,差异有统计学意义(P<0.05).多因素Logistic 回归分析显示年龄、收缩压(SBP)是动脉血管斑块的独立危险因素(P<0.001), HDL-C是动脉血管斑块的保护因素(P<0.05).结论 糖尿病患者外周动脉血管斑块检出率高,其发生发展与年龄、病程、餐后血糖、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇密切相关.%Objective To investigate the positive rate of carotid and lower limb artery plaques of hospitalized patients with type 2 diabetes in our hospital(primary hospital),and to analyze clinical factors,biochemical indexes,and risk factors related to the plaques.Methods As a retrospective study,medical records of 482 patients with type 2 diabetes who hospitalized in Guoguang E-lectric Co.,Ltd.Chengdu hospital from June 2015 to February 2017 were collected,and patients were divided into group without plaque(Group A),group with simple carotid or lower limb artery plaques(Group B),group with both carotid and lower limb artery plaques(Group C)according to the color Doppler ultrasound findings of carotid and lower extremity arteries.Results Total posi-tive rate was 86.10%,among which there were 17(3.5%)with simple carotid artery plaques,77(15.98%)with simple lower limb artery plaques,321(66.60%)with both carotid and lower limb artery plaques.Compared with group without plaque,patients in the compound plaque group were older,with longer illness duration,of which the 2 hour postprandial blood glucose(PPG)and low den-sity lipoprotein cholesterol(LDL-C)were higher,while the high density lipoprotein cholesterol(HDL-C)was low,and the difference was statistically significant(P<0.05);with higher rate to complicating with hypertension,stroke and coronary heart disease,statis-tically significant(P<0.05).The multiple logistic regression analysis showed that age and SBP were independent risk factors of artery plaques(P<0.001),and HDL-C was protective factor of artery plaques(P<0.05).Conclusion Diabetic patients have a high positive rate of peripheral artery plaques,the occurrence and development of which are closely related to age,illness duration, PPG,LDL-C and HDL-C.