踝臂指数评价糖尿病合并下肢动脉病患者治疗效果研究

目的探讨踝臂指数(ABI)作为糖尿病合并下肢动脉病(PAD)患者治疗效果评价指标的价值。方法糖尿病合并PAD患者106例,随机分为两组:单纯药物治疗(A组)64例,其中男38例,女26例;平均(74±6)岁;介入治疗+药物治疗(B组)42例,其中男29例,女13例,平均(73±5)岁。分别于治疗前及治疗后1、3、6、12个月检测ABI。结果老年糖尿病合并PAD患者治疗前ABI<0.90。B组治疗后1、3、6、12个月的ABI与治疗前相比,差异均有统计学意义(P<0.05)。B组中11例于治疗后12个月ABI<0.90,经下肢动脉造影证实支架内再狭窄。治疗后1、3、6、12个月两组的ABI比较,差异均有统计学意义(P<0.01)。结论介入治疗能够及早改善老年糖尿病合并PAD患者的血运,比单纯药物治疗疗效显著。ABI在评价治疗效果中起着重要的作用。

Application of Ankle-brachial Index for Evaluating Therapeutic Effectiveness of Peripheral Arterial Disease in Aged Diabetic Patients

Objective To explore the feasibility of using ankle-brachial index(ABI) for evaluating the treatment outcomes of peripheral arterial disease(PAD) in the aged patients with type 2 diabetes mellitus(T2DM).Methods Totally 106 elderly T2DM patients with PAD were randomly divided into two groups:group A receiving simple drug treatment(n = 64;38 males and 26 females;average age:74±6 years) and group B receiving interventional therapy and drug treatment(n = 42;29 males and 13 females;average age:73±5 years).All the patients were checked for ABI before treatment and 1,3,6,and 12 months after treatment.Results ABI was <0.90 in elderly T2DM patients with PAD before treatment.In group B,ABI significantly changed 1,3,6,and 12 months after treatment(P<0.05).Also in group B,ABI was less than 0.90 after 12 months′ treatment,and in-stent re-stenosis was confirmed by lower-extremity arteriography in these patients.ABI between group A and group B showed significant differences after 1,3,6,and 12 months of treatment(P>0.05).Conclusion Interventional therapy can improve the blood circulation in elderly T2DM patients with PAD earlier and more effective than simple drug treatment.ABI can be a useful indicator for evaluating the treatment effectiveness of PAD.