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目的探讨与2型糖尿病相关的周围动脉粥样硬化性疾病(PAD)发病的相关危险因素。方法用高分辨彩色多普勒超声诊断仪确定102例2型糖尿病的PAD诊断,危险因素分析采用多因素Logistic回归法。结果住院患者2型糖尿病相关的PAD发病率为65.7%,男性发病明显高于女性。多因素Logistic回归分析显示高龄、男性、病程长、高收缩压、低胰岛素敏感指数及高血清基质金属蛋白酶(MMP)-9是PAD的发病的独立危险因素,各OR值(95%CI)分别为:年龄:1.72(1.03,2.33);性别:1.21(0.89,2.40);病程:1.17(1.02,3.24);收缩压:2.63(1.61,4.28);胰岛素敏感指数:2.33(0.92,3.04);MMP-9:1.56(1.15,2.84)。结论高龄、男性、病程长、高收缩压和胰岛素抵抗是PAD发病的危险因素,血清MMP-9可预测2型糖尿病PAD病变及程度。
Objective To investigate the related risk factors of peripheral atherosclerotic disease (PAD) associated with type 2 diabetes. Methods The diagnosis of PAD in 102 patients with type 2 diabetes mellitus was confirmed by high resolution color Doppler sonography. The risk factors were analyzed by multivariate Logistic regression. Results The incidence of type 2 diabetes-related PAD in hospitalized patients was 65.7%, and the incidence of male patients was significantly higher than that of women. Multivariate logistic regression analysis showed that elderly, men, long duration, high systolic pressure, low insulin sensitivity index and high serum matrix metalloproteinase (MMP-9) were independent risk factors for PAD. The OR values (95% CI) Were as follows: age: 1.72 (1.03,2.33); gender: 1.21 (0.89,2.40); course of disease: 1.17 (1.02,3.24); systolic pressure: 2.63 (1.61,4.28); insulin sensitivity index: 2.33 MMP-9: 1.56 (1.15, 2.84). Conclusion The elderly, men, long duration of disease, high systolic pressure and insulin resistance are the risk factors for the pathogenesis of PAD. Serum MMP-9 can predict the extent and extent of PAD in type 2 diabetes mellitus.