下肢动脉超声筛查对2型糖尿病患者冠状动脉病变的提示价值
[Abstract]:Objective to determine whether ultrasound screening of lower extremity arterial diseases may be useful for coronary atherosclerotic heart disease (CHD) in type 2 diabetic patients. Methods A total of 606 patients with type 2 diabetes were enrolled in this study. The liver and kidney function, glucose metabolism and tumor indexes were measured. The lower extremity artery ultrasound and coronary CT angiography (CTA) were performed. According to the results of arterial ultrasound, the patients were divided into two groups: (LEAD) group with diabetes mellitus lower extremity atherosclerotic lesion (nf318) and group without LEAD (nnc288); (PCI) history or percutaneous transluminal coronary artery intervention (PTCA) with coronary CTA or percutaneous coronary intervention was used to treat patients with diabetic lower extremity atherosclerotic lesions. History of angioplasty (PTCA), The patients were divided into two groups: coronary heart disease group (n = 280) and non-coronary heart disease group (n ~ (326). To analyze the prevalence and relationship of coronary heart disease in patients with different arterial lesions of lower extremity. Results the prevalence of coronary heart disease in patients with type 2 diabetes increased with the exacerbation of arterial lesions of lower extremities. The prevalence of coronary heart disease in the arteriosclerosis of lower extremity group was 29. The prevalence rate of coronary heart disease was 63 in the group with plaque and artery stenosis of lower extremity less than 50%. The prevalence rate of coronary heart disease was 81 in the group of arteriosclerosis of lower extremity more than 50% or in the group of occlusion. Age of association with LEAD group (P0. 021, P0. 015). Spearman correlation analysis, P < 0. 021). Sex, course of diabetes, systolic blood pressure, serum total cholesterol, arteriopathy of lower extremity, medial thickness of femoral artery were positively correlated with the prevalence of coronary heart disease, while high density lipoprotein cholesterol, The glomerular filtration rate was negatively correlated with the prevalence of coronary heart disease. Logistic regression analysis further found that the course of diabetes, arterial lesions of lower extremities and the prevalence of coronary heart disease were independently correlated. OR analysis of arterial lesion and coronary heart disease showed that the risk of coronary heart disease in patients with lower extremity artery disease was increased by 4.818 times (OR=5.818,95%CI = 2.627 ~ 12.888P0. 000) after adjusting for age, diabetes course, blood lipid and other influencing factors. Conclusion the lower extremity artery lesions can indicate the risk of coronary artery disease.
【作者单位】: 上海市糖尿病临床医学中心上海市"重中之重"代谢病临床医学中心上海市糖尿病研究所上海市糖尿病重点实验室上海交通大学附属第六人民医院内分泌代谢科;
【基金】:国家自然科学基金(81270397) 上海市教育委员会高峰高原学科建设计划(20152232)~~
【分类号】:R445.1;R587.2
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