·糖尿病与大血管病变·

　　【摘 要】目的 研究老年稳定性心绞痛合并T2DM患者踝肱指数异常情况及临床意义。方法 选择稳定性心绞痛合并T2DM(SAP+T2DM组)老年患者50例,稳定性心绞痛(SAP组)老年患者48例, T2DM(T2DM组)老年患者35例,测定踝肱指数(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组、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+T2DM组与SAP组、T2DM组MPO、hsCRP水平比较差异有统计学意义[(274.3±91.4) 、(109.7±28.7) 和(107.4±18.6) mmol/L;(7.93±2.8) vs (1.53±0.5) vs (1.18±0.6) mg/dL，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。

　　【关键词】老年;稳定性心绞痛;糖尿病，2型;踝肱指数;高敏C反应蛋白;髓过氧化物酶;血管内皮功能

Clinical study on the impaired ankle brachial index in elderly patients complicated with stable angina pectoris and type 2 diabetes mellitus LU Qing, DING Shi-fang, JIANG Ju-quan, et al. Department of Cardiology, Wuhan General Hospital of Guangzhou Military Command, Wuhan 430070, China

Corresponding author: DING Shi-fang, E-mail: dsfmd@yahoo.com.cn

　　【Abstract】 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 (hsCRP) and myeloperoxidase (MPO) were also assessed. Results ABI was significantly lower in value in the SAP+T2DM group than in the SAP and T2DM groups [(0.46±0.19) vs (0.96±0.17) vs (0.97±0.12), P<0.05]. The levels of MPO and hsCRP were significantly higher in the SAP+T2DM group than in the SAP and T2DM groups [(274.3±91.4), (109.7±28.7), (107.4±18.6) mmol/L; (7.93±2.8) vs (1.53±0.5) vs (1.18±0.6) mg/dL, P<0.05]; and FMD in the brachial artery was significantly lower in the SAP+T2DM group than in the SAP and 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.

　　【Key words】Elderly patients; Stable angina pectoris; Diabetes mellitus, type 2; Ankle brachial index; High sensitive C-reactive protein; Myeloperoxidase; Vascular endothelial function