目的探讨2型糖尿病下肢血管病变(PAD)患者的踝肱指数(ABI)与尿白蛋白、可溶性细胞间黏附分子-1(slCAM-1)的关系。方法分析342例2型糖尿病患者测得的ABI、24h尿白蛋白(24h-gAlb)、空腹血糖(FBG)、餐后2h血糖(2hBG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL—C)、slCAM-1水平,其中ABI≤0.9患者为下肢血管病变(PAD)组,48例,占14.8%;0.9〈ABI〈1.3的为非PAD组,294例。两组患者的ABI病程、年龄、24h-μAlb、FBG、2hBG、TG、HDL—C、LDL—C水平采用i±s表示,组问比较采用t检验,ABI与各指标的相关分析采用多元线性回归分析。结果PAD组尿白蛋白[(125.4±108.2)mg,(67.6±55.5)mg,t=5.47,P〈0.05]和sICAM—1[(278.6±234.1)ng/ml,(161.5±115.2).g/ml,t=5.01,P〈0.05]、年龄[(67.7±15.4)岁,(54.2±12.8)岁,t=3.08,P〈0.05]、病程[(15.4±14.1)年,(8.2±7.5)年,t=4.06,P〈0.05]、LDL—C[(1.8±1.7)mmol/L,(1.0±1.1)mmol/L,t=6.85,P〈0.05]、2hBG[(15.8±5.2)mmol/L,(11.0±4.4)mmol/L,t=2.96,P〈0.05]水平均高于非PAD组。差异有统计学意义;ABI值[(0.8±0.2),(1.2±0.2)]水平则低于非PAD组,差异有统计学意义(t=3.53,P〈0.05)。PAD患者ABI与24h-μA1b(r=-0.207,P〈0.05)、sICAM-1水平呈负相关(r=-0.201,P〈0.05)。结论ABI可作为筛查2型糖尿病患者下肢血管病变与糖尿病肾病的方法,并反映其炎症指标。
Objective To study the relationship of ankle?brachial index ( ABI ) and the urinary albumin,soluble intercellular adhesion molecule?1(sICAM?1) in patients with type 2 diabetic peripheral arterial disease ( PAD) . Methods Three hundred and forty?two patients with T2DM were divided into two groups according to the results of ABI,forty?eight cases in PAD group(ABI≤0.9) and two hundred and ninty four cases in non?PAD group(0.9