·糖尿病大血管病·

　　【摘要】 目的 探讨不同部位T2DM患者血管病变的相关危险因素。 方法 对1644例T2DM患者行血管彩色多普勒超声检查，根据检测结果分为单纯T2DM组(T2DM组)463例、单纯颈部血管病变组226例、单纯下肢血管病变组372例及颈部+下肢复合血管病变组583例，比较各组临床指标和糖尿病合并症及并发症的差异。 结果 (1)单纯颈部血管病变组年龄、LDL-C、TC、病程大于5年的比例、肥胖、高血压病、冠心病(CHD)、脑梗死(CI)的患病率均高于T2DM组，而男性比例、FPG、HbA1c低于T2DM组(P<0.05);(2)单纯下肢血管病变组年龄、HLD-C、病程大于5年的比例、高血压病、冠心病、脑梗死、DR、糖尿病周围神经病变(DPN)的患病率均高于T2DM组(P<0.05)，而FPG、HBA1c低于T2DM组(P<0.05);(3)颈部+下肢复合血管病变组年龄、病程大于5年的比例、LDL-C、高血压病、冠心病、脑梗死、DPN、糖尿病慢性肾脏疾病(CKD)及高尿酸血症(HUA)的患病率均高于T2DM组(P<0.05)，FPG、HBA1c低于T2DM组(P<0.05);(4)Logistic回归分析显示，年龄、LDL-C与糖尿病合并颈部血管病变相关(P<0.05);年龄、DR与糖尿病合并下肢部血管病变相关(P<0.05);年龄、病程、LDL-C、DN、DPN与糖尿病合并颈部+下肢复合血管病变相关(P<0.05)。 结论 T2DM不同部位周围血管病变的危险因素并不完全一致。

　　【关键词】 糖尿病，2型;周围血管病变;危险因素

　　【Abstract】 Objective To explore the characteristics of vascular disease in patients with type 2 diabetes (T2DM) and its related risk factors. Methods 1644 patients with T2DM received ultrasound scanning, then all subjects were divided into T2DM group(n=463), neck vascular lesions group(n=226), lower extremities vascular lesions group(n=372) and neck+lower extremities vascular lesions group(n=583). Clinical indices, diabetic complications and comorbidities were compared among four groups. Results (1)Age, LDL-C, TC, course≥5 years, obesity, hypertension, coronary heart disease(CHD), cerebral infarction(CI) were higher in neck vascular lesions group than in T2DM group, and male sex, FPG, HbA1c were lower(all P<0.05); (2)Age, HDL-C, course≥5 years, hypertension, CHD, CI, DR, diabetic nephropathy disease(DPN) were higher in lower extremities vascular lesions group than in T2DM group, and FPG, HbA1c were lower(all P<0.05). (3)Age, course≥5 years, LDL-C, hypertension, CHD, CI, DPN, chronic kidney disease(CKD) and hyperuricemia(HUA) were higher in neck+lower extremities vascular lesions group than in T2DM group, and FPG, HbA1c were lower(all P<0.05); (4)Logistic regression analysis showed that age and LDL-C were correlated with neck vascular lesions in T2DM(P<0.05); age and DR were correlated with lower extremities vascular lesions in T2DM(P<0.05); age, course, LDL-C, DN and DPN were correlated with neck+lower extremities vascular lesions in T2DM(P<0.05). Conclusion Risk factors related to different peripheral vascular disease in T2DM were not entirely consistent.

　　【Key words】 Diabetes mellitus, type 2; Peripheral vascular disease; Risk factors