目的 了解老年2型糖尿病动脉僵硬度与踝臂指数(ABI)对评价外周动脉硬化的价值。 方法 2010年1月-3月,应用超声、回声跟踪技术和动脉硬化检测仪检测80例老年2型糖尿病患者(观察组)和40例正常老年人(对照组)的颈总动脉内中膜厚度(IMT)、僵硬系数(β)、脉搏波传导速度(PWVβ)、ABI及动脉斑块情况。 结果 与对照组比较,观察组患者的IMT增厚、β增高、PWVβ增快、ABI降低及动脉斑块发生率增多,差异均具有统计学意义(P<0.001)。 结论 老年2型糖尿病可导致IMT增厚、动脉僵硬度增高、PWVβ增快、ABI降低及更易发生动脉粥样硬化斑块,这些参数可以预测外周动脉粥样硬化的程度,利用彩色多普勒超声诊断仪和动脉硬化检测仪可以较容易得到这些参数,是评价外周动脉粥样硬化病变一种简便、易行,有临床实际意义的方法和手段。
ObjectivesTo investigate the level of ankle-brachial index (ABI) of health examination population in Chongqing municipality and analyze the risk factors related to the level of ABI, so as to provide basis for effective evaluation of atherosclerotic lesions and their severity, as well as early detection, intervention and treatment of clinical cardiovascular diseases. MethodsA total of 22 886 subjects aged from 20 to 85 undergoing health examination in the medical examination center of First Affiliated Hospital of Chongqing Medical University in Chongqing municipality from January to December in 2016 were retrospectively analyzed. ABI and related physiological and biochemical data were collected. The relationship between ABI and age was analyzed using stepwise logistic regression model combined with restricted cubic splines. ResultsThe detection rate of abnormal ABI was 3.31% in 22 886 subjects undergoing health examination with 2.90% in males and 3.92% in females. The subjects aged below 40 presented the highest detection rate of abnormal ABI (6.17%) with 4.72% in males and 8.66% in females. The subjects were divided into two groups, one with ABI≤0.9 and one with ABI>0.9; the differences in age and levels of body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) between the two groups were statistically significant (allP<0.05). Multivariate stepwise logistic regression combined with restricted cubic splines showed that age, gender and BMI were presented as independent factors affecting ABI, among which the age below 40 (OR=2.885, 95%CI (2.445, 3.404),P<0.0001) was the main risk factor. A curve relating age to probability of abnormal ABI was produced after correcting for the influences of sex and BMI, stratified by gender and BMI into different subgroups, showing a U-shaped curve of decreasing initially and then increasing between the probability of abnormal ABI and age. ConclusionsThe detection rate of abnormal ABI based on individuals undergoing health examination in Chongqing municipality was 3.31%. A U-shaped curve of downward trend followed by an upward one was shown between probability of abnormal ABI and age after correcting for the influences of gender and BMI. The clinical significance of ABI≤0.9 for youth population (20 to 40 years old) without cardiovascular risk factors requires further exploration.