Jude E B, Oyibo S O, Chalmers N, Boulton A J
Department of Medicine, Manchester Royal Infirmary, Manchester, UK.
Diabetes Care. 2001 Aug;24(8):1433-7. doi: 10.2337/diacare.24.8.1433.
The aim of this study was to quantify the distribution of peripheral arterial disease in the diabetic and nondiabetic population attending for angiography and to compare severity and outcome between both groups of patients.
Randomly selected lower-extremity angiograms were examined according to the Bollinger system. Patient demographics and medical history were recorded and case notes were examined to determine which patients later underwent a revascularization procedure or amputation and which patients had died.
A total of 136 arteriograms obtained between 1992 and 1996 were analyzed. The age (mean +/- SD) of the patients was 64.7 +/- 10.8 years. Diabetic patients (43%) and nondiabetic patients were of similar age (63.9 +/- 10.4 vs. 65.3 +/- 11.1 years, P = 0.43), with a similar history of smoking (81.0 vs. 76.9%, P = 0.26), ischemic heart disease (41.4 vs. 37.2%, P = 0.54), and hypercholesterolemia (24.4 vs. 30.8%, P = 0.48). However, there were a greater proportion of hypertensive patients in the diabetic group (63.8 vs. 39.7%, P = 0.006). Diabetic patients had greater severity of arterial disease in the profunda femoris and all arterial segments below the knee (P = 0.02). A greater number of amputations occurred in the diabetic group: diabetic patients were five times more likely to have an amputation (41.4 vs. 11.5%, odds ratio [OR] 5.4, P < 0.0001). Mortality was higher in the diabetic group (51.7 vs. 25.6%, OR 3.1, P = 0.002), and diabetic patients who died were younger at presentation than nondiabetic patients (64.7 +/- 11.4 vs. 71.1 +/- 8.7 years, P = 0.04).
In patients with peripheral arterial disease, diabetic patients have worse arterial disease and a poorer outcome than nondiabetic patients.
本研究旨在量化接受血管造影的糖尿病患者和非糖尿病患者外周动脉疾病的分布情况，并比较两组患者的疾病严重程度和预后。
根据博林格系统对随机选取的下肢血管造影进行检查。记录患者的人口统计学资料和病史，并查阅病历以确定哪些患者后来接受了血运重建手术或截肢手术，以及哪些患者已经死亡。
对1992年至1996年间获得的136份血管造影进行了分析。患者的年龄（均值±标准差）为64.7±10.8岁。糖尿病患者（43%）和非糖尿病患者年龄相似（63.9±10.4岁对65.3±11.1岁，P = 0.43），吸烟史相似（81.0%对76.9%，P = 0.26），缺血性心脏病史相似（41.4%对37.2%，P = 0.54），高胆固醇血症史相似（24.4%对30.8%，P = 0.48）。然而，糖尿病组高血压患者的比例更高（63.8%对39.7%，P = 0.006）。糖尿病患者股深动脉及膝以下所有动脉节段的动脉疾病严重程度更高（P = 0.02）。糖尿病组截肢的患者更多：糖尿病患者截肢的可能性是非糖尿病患者的5倍（41.4%对11.5%，优势比[OR] 5.4，P < 0.0001）。糖尿病组的死亡率更高（51.7%对25.6%，OR 3.1，P = 0.002），且死亡的糖尿病患者就诊时比非糖尿病患者更年轻（64.7±11.4岁对71.1±8.7岁，P = 0.04）。
在外周动脉疾病患者中，糖尿病患者的动脉疾病比非糖尿病患者更严重，预后更差。
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