沈芸 张琳 吴亚楠 李灿晖 毕鸿雁 苏克智 卜锐

　　基金项目：云南省教育厅科研基金项目(5Z0459C)

　　作者单位：650032 昆明医学院第一附属医院干疗科

　　【摘要】 目的 探讨老年2型糖尿病(T2DM)患者下肢静脉病变的特点及其相关因素。方法 133例老年T2DM患者和125例对照组行双下肢血管二维彩色多普勒超声检查，糖尿病组62例行UAlb、HbA1c、hsC-RP、FIns及2hIns和C-P，并分析上述指标与下肢静脉病变的关系。 结果 (1)糖尿病组静脉瓣功能不全检出率高于对照组(P<0.01);(2)糖尿病组静脉血峰值流速较对照组减慢(P<0.05)，小腿部淤血程度重于对照组(P<0.01);(3)糖尿病组静脉瓣功能不全与年龄及动脉硬化相关。 结论 老年T2DM患者多普勒超声检查下肢静脉病变主要表现为下肢静脉瓣膜功能不全、静脉血峰值流速减慢和小腿静脉淤血;下肢深静脉瓣膜功能不全可能参与糖尿病足的发生和发展，应在糖尿病足的防治中加以重视。

　　【关键词】老年;糖尿病，2型;静脉瓣功能不全; 下肢; 糖尿病足

　　doi:10.3969/j.issn.1006-6187.2011.02.007

　　The study of lower limb venous lesion in elderly with type 2 diabetes

　　SHEN Yun, ZHANG Lin, WU Ya-nan，et al. Department of Geriatrics, The First Affiliated Hospital of Kunming Medical College, Kunming 650032,China

　　【Abstract】 Objective To investigate the lower limb venous lesions in the elderly with type 2 diabetes. Methods 133 elderly patients with type 2 diabetes mellitus and 125 control group received Doppler ultrasonic examination on lower limbs. UAlb, HbA1c, hsC-RP, insulin and C-peptide were tested in 62 elderly patients with type 2 diabetes mellitus. Results The detection rate of lower limb venous valve insufficiency was higher in type 2 diabetes than in control group(P<0.01).The speed of blood flow was slower in T2DM than in NC (P<0.05). And the degree of leg congestion was severer in T2DM than in NC(P<0.01). The lower limb venous valve insufficiency was correlated with age and arteriosclerosis. Conclusion The Doppler-detected lower limb venous lesions included venous valve insufficiency, slowed speed of blood flow and aggravated congestion in lower limbs. The venous valve insufficiency in lower limbs may promote the development of diabetic foot.

　　【Key words】Elderly; Diabetes mellitus, type 2; Venous valve insufficiency; Lower limb; Diabetic foot