·糖尿病与大血管病·

　　【摘要】 目的 了解尚未达到周围血管病变(PAD)诊断标准的糖尿病患者大血管病变的发生情况。 方法 ABI>0.9的住院T2DM患者601例，根据血管彩超结果分为无病变组和有病变组，另根据病变部位将有病变组分为下肢血管病变亚组、颈部血管病变亚组及多部位病变亚组进行比较分析。 结果 64.2%(386/601)的患者存在不同程度的大血管病变，其中单纯下肢动脉病变者占44.6%(172/386)，单纯颈动脉病变者占13.5%(52/386)，多部位病变者占41.9%(162/386)。与无病变组相比，有病变组TG、FIns、2 hIns水平均较低，糖尿病性慢性肾脏疾病(CKD)及冠心病的患病率升高，比较差异有统计学意义(P<0.05)。Logistic回归分析显示，CKD是血管病变发生的独立危险因素。 结论 在依据ABI诊断下肢动脉粥样硬化之前，血管彩超显示已有64.2%的糖尿病患者存在不同程度的大血管病变。

　　【关键词】 血管彩超;糖尿病，2型;颈动脉;下肢动脉;患病率

　　【Abstract】 Objective To investigate the prevalence of peripheral arterial lesions by color Doppler ultrasonography in type 2 diabetes mellitus. Methods 601 patients with type 2 diabetes and ABI>0.9 were divided into normal group and abnormal group according to the result of color Doppler ultrasound. Then using the Doppler ultrasound results, the 386 patients were stratified into 3 groups, which included 44.6%(172/386) patients in the lower extremity artery disease subgroup, 13.5%(52/386) patients in the carotid artery disease subgroup and 41.9%(162/386) patients in the multi-position lesion subgroup. Result The total prevalence of peripheral arterial lesions was 64.2%(386/601), and the prevalence of lower extremity artery disease , carotid artery disease and multi-position disease was 44.6%(172/386), 13.5%(52/386) and 41.9%(162/386). The levels of TG, FIns and 2 hIns were lower ,and the prevalence of diabetic nephropathy and coronary disease was higher in abnormal group than in normal group(P<0.05). Multivariate conditional logistic regression analysis showed that the CKD was an independent risk factor for peripheral arterial lesions. Conclusion The prevalence of peripheral arterial lesions was 64.2% before diagnosing as PAD (ABI≤0.9).

　　【Key words】 Color Doppler ultrasound;Diabetes mellitus，type 2;Carotid artery;Lower extremity artery; Prevalence