Papanas N, Tziakas D, Maltezos E, Kekes A, Hatzinikolaou E, Parcharidis G, Louridas G, Hatseras D
Second Department of Internal Medicine, Democritus University of Thrace, Greece.
Acta Clin Belg. 2005 May-Jun;60(3):129-34. doi: 10.1179/acb.2005.024.
The aim of the study was to evaluate the impact of Diabetes Mellitus (DM) on severity of concomitant Peripheral Arterial Occlusive Disease (PAOD) in patients with Coronary Artery Disease (CAD).
This study included 302 patients (229 men) with a mean age of 62.2 +/- 11.5 years who had angiographically documented CAD. Patients were divided into Group I (severe CAD), Group II (moderate CAD) and Group III (mild CAD). Each of the groups I-III was divided into subgroups comprising diabetic patients (subgroups Ia, IIa, IIIa) and non-diabetic patients (subgroups Ib, IIb, IIIb). PAOD was evaluated by measurement of Toe-Brachial Index (TBI).
PAOD was diagnosed in 69 patients (22.8%). Symptoms of PAOD (intermittent claudication or rest pain) were present in 38 patients (55%), while 31 patients (45%) were asymptomatic. Frequency of symptoms attributable to PAOD did not differ (p = 0.43) between diabetic patients (25 out of 49 patients, 51%) and non-diabetic patients (13 out of 20 patients, 65%). TBI was significantly (p = 0.04) lower in diabetic (0.41 +/- 0.03) than in non-diabetic patients with PAOD (0.51 +/- 0.03). This significant difference was found in each of the Groups I-III. Severity of PAOD was significantly associated with angiographic gravity of CAD, both in diabetic (p = 0.046) and in non-diabetic patients (p = 0.047).
DM has an adverse impact on severity of concomitant PAOD in patients with CAD. This impact does not depend on angiographic gravity of CAD. However, the association between severity of PAOD and angiographic gravity of CAD is demonstrated both in diabetic and in non-diabetic patients.
本研究旨在评估糖尿病（DM）对冠状动脉疾病（CAD）患者合并的外周动脉闭塞性疾病（PAOD）严重程度的影响。
本研究纳入302例患者（229例男性），平均年龄62.2±11.5岁，均经血管造影证实患有CAD。患者分为I组（重度CAD）、II组（中度CAD）和III组（轻度CAD）。I - III组中的每一组又分为包含糖尿病患者的亚组（Ia、IIa、IIIa亚组）和非糖尿病患者的亚组（Ib、IIb、IIIb亚组）。通过测量趾臂指数（TBI）评估PAOD。
69例患者（22.8%）被诊断为PAOD。38例患者（55%）出现PAOD症状（间歇性跛行或静息痛），而31例患者（45%）无症状。糖尿病患者（49例中的25例，51%）和非糖尿病患者（20例中的13例，65%）中归因于PAOD的症状发生率无差异（p = 0.43）。糖尿病合并PAOD患者的TBI（0.41±0.03）显著低于非糖尿病合并PAOD患者（0.51±0.03）（p = 0.04）。在I - III组中均发现了这一显著差异。PAOD的严重程度与CAD的血管造影严重程度显著相关，在糖尿病患者（p = 0.046）和非糖尿病患者中均如此（p = 0.047）。
DM对CAD患者合并的PAOD严重程度有不利影响。这种影响不取决于CAD的血管造影严重程度。然而，PAOD严重程度与CAD血管造影严重程度之间的关联在糖尿病患者和非糖尿病患者中均得到证实。
