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[2型糖尿病患者下肢动脉粥样硬化血管床受累的临床表现及特征]

[Clinical manifestations and characteristics of vascular bed involvement in atherosclerosis of lower extremities in patients with type 2 diabetes].

作者信息

Nosenko E M, Sidorenko B A, Koshkin V M, Dadova L V, Gracheva O A, Koshkina I V, Ushakova T I

出版信息

Kardiologiia. 2003;43(3):36-42.

Abstract

Clinical manifestations of arterial insufficiency and characteristics of vascular damage were compared in 68 patients (54 men, 14 women, mean age 64.5+/-1.1 years) with atherosclerosis of arteries of lower extremities including 40 patients with type 2 diabetes. Color duplex scanning was used for assessment of severity of vascular wall involvement. Ankle blood pressure was measured by Doppler technique with calculation of ankle-brachial index. Atherosclerosis of arteries of lower extremities in patients with diabetes manifested clinically as neuropathy while intermittent claudication was more characteristic of patients without diabetes. Severity of medial calcinosis and vascular wall rigidity were related to duration of diabetes. Ankle-brachial index in patients with diabetes was 20-30% and 1.5-2 times higher compared with those without diabetes with similar occlusive and nonocclusive changes of arteries of lower extremities, respectively. Color duplex scanning did not reveal differences between patients with and without diabetes in frequency of large multiple atherosclerotic plaques in abdominal aorta, iliac, popliteal arteries.

摘要

对68例(54例男性,14例女性,平均年龄64.5±1.1岁)下肢动脉粥样硬化患者(其中40例为2型糖尿病患者)的动脉供血不足临床表现和血管损伤特征进行了比较。采用彩色双功能超声扫描评估血管壁受累的严重程度。用多普勒技术测量踝部血压并计算踝臂指数。糖尿病患者的下肢动脉粥样硬化临床上表现为神经病变,而间歇性跛行在非糖尿病患者中更为典型。中层钙化和血管壁僵硬的严重程度与糖尿病病程有关。与下肢动脉有类似闭塞性和非闭塞性改变的非糖尿病患者相比,糖尿病患者的踝臂指数分别低20 - 30%和高1.5 - 2倍。彩色双功能超声扫描未发现糖尿病患者与非糖尿病患者在腹主动脉、髂动脉、腘动脉多发大的动脉粥样硬化斑块频率上存在差异。

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