本文選題：2型糖尿病 + 下肢血管病變�。� 參考：《南昌大學(xué)》2017年碩士論文

【摘要】：目的:踝肱指數(shù)(ABI)是篩查糖尿病下肢動(dòng)脈疾病(LEAD)的一項(xiàng)簡(jiǎn)便、無(wú)創(chuàng)、廣泛使用的篩查手段。但由于需要固定的檢查設(shè)備,ABI篩查在初級(jí)醫(yī)療機(jī)構(gòu)的應(yīng)用受到一定限制,并且對(duì)于血管局限性狹窄或廣泛血管鈣化的患者,ABI的檢查結(jié)果有時(shí)并不能反應(yīng)真實(shí)的血管狀態(tài)。間歇性跛行(IC)風(fēng)險(xiǎn)評(píng)分是來(lái)自于Framingham心臟研究的一項(xiàng)評(píng)分,以年齡、性別、血漿膽固醇水平、高血壓、吸煙史、糖尿病、冠心病七個(gè)因素為預(yù)測(cè)因子進(jìn)行系統(tǒng)評(píng)分,以預(yù)測(cè)未來(lái)4年間歇性跛行的發(fā)生概率,該評(píng)分也被國(guó)外一些機(jī)構(gòu)用來(lái)對(duì)LEAD進(jìn)行評(píng)估。本研究的主要目是1、了解2型糖尿病患者發(fā)生LEAD的危險(xiǎn)因素并在ABI篩查基礎(chǔ)上探索更有效、便捷的篩查公式。2、評(píng)估ABI和IC風(fēng)險(xiǎn)分?jǐn)?shù)用于糖尿病LEAD預(yù)測(cè)價(jià)值。3、比較ABI和IC風(fēng)險(xiǎn)分?jǐn)?shù)對(duì)LEAD的預(yù)測(cè)價(jià)值。方法:研究對(duì)象來(lái)自南昌大學(xué)第一附屬醫(yī)院內(nèi)分泌科門診以及住院部符合納入標(biāo)準(zhǔn)的2型糖尿病患者,采集患者就診時(shí)的病歷資料,包括:年齡、性別、糖尿病病程、吸煙史、高血壓病史、冠心病病史,檢測(cè)空腹血糖、血脂四項(xiàng),計(jì)算出每位患者的IC風(fēng)險(xiǎn)分?jǐn)?shù)。另外,對(duì)每位患者進(jìn)行踝肱指數(shù)(ABI)測(cè)定以及下肢血管彩色多普勒超聲檢查。以下肢血管彩超結(jié)果作為臨床終點(diǎn)事件,分別以ABI值和IC風(fēng)險(xiǎn)評(píng)分與下肢彩超結(jié)果進(jìn)行Spearman相關(guān)分析,并采用ROC分析對(duì)IC以及ABI對(duì)LEAD的預(yù)測(cè)價(jià)值進(jìn)行評(píng)價(jià)。結(jié)果:研究共納入252例患者,其中左下肢ABI與左下肢彩超結(jié)果同時(shí)收集到的病例數(shù)為236例,左下肢ABI與左下肢血管彩超異常呈負(fù)相關(guān)(P0.01,r=-0.186);右下肢ABI與右下肢彩超結(jié)果同時(shí)收集到的病例數(shù)為238例,右下肢ABI與右下肢血管彩超異常呈負(fù)相關(guān)(P0.01,r=-0.199)。IC與LEAD: IC與左下肢彩超結(jié)果同時(shí)收集到的病例數(shù)為249例,IC值與左下肢血管彩超異常呈正相關(guān)(r=0.250, P0.01);右下肢I(xiàn)C與右下肢彩超結(jié)果同時(shí)收集到的病例數(shù)為250例,IC值與右下肢血管彩超異常呈正相關(guān)(r=0.245, P0.01)。對(duì)IC和ABI的預(yù)測(cè)價(jià)值進(jìn)行ROC分析,結(jié)果無(wú)論是左側(cè)還是右側(cè)的預(yù)測(cè)結(jié)果,IC的AUC值均高于ABI。結(jié)論:下肢ABI與下肢血管彩超異常呈負(fù)相關(guān)(P0.01) , IC風(fēng)險(xiǎn)分?jǐn)?shù)與下肢血管彩超異常呈正相關(guān)(r=0.250,P0.01),ABI與LEAD風(fēng)險(xiǎn)呈負(fù)相關(guān),IC風(fēng)險(xiǎn)分?jǐn)?shù)與LEAD風(fēng)險(xiǎn)呈正相關(guān);IC評(píng)分對(duì)LEAD的預(yù)測(cè)高于ABI。
[Abstract]:Objective: malleolus brachial index (ABI) is a simple, non-invasive and widely used method for screening diabetic lower extremity arterial diseases. However, the application of ABI screening in primary medical institutions is limited due to the need for fixed equipment, and the results of ABI in patients with localized stenosis or extensive calcification of blood vessels sometimes do not reflect the true blood vessel status. The intermittent claudication risk score, a score from the Fraingham Heart study, was systematically rated as a predictor of seven factors: age, sex, plasma cholesterol levels, hypertension, smoking history, diabetes, and coronary heart disease. In order to predict the probability of intermittent claudication in the next four years, the score has also been used by some foreign institutions to evaluate read. The main purpose of this study is to understand the risk factors of Lead in type 2 diabetic patients and to explore the effectiveness of ABI screening. To evaluate the predictive value of ABI and IC risk scores in diabetes mellitus read, the predictive value of ABI and IC risk scores to read was compared. Methods: patients with type 2 diabetes were collected from the Department of Endocrinology, Department of Endocrinology, first affiliated Hospital of Nanchang University and inpatient department. The medical records of the patients were collected, including age, sex, course of diabetes, history of smoking. The history of hypertension, coronary heart disease, fasting blood glucose and blood lipids were measured to calculate the IC risk score of each patient. In addition, the ankle-brachial index (ABI) and lower extremity vascular color Doppler ultrasound were measured in each patient. Using the results of lower extremity color Doppler ultrasound as the clinical endpoint, Spearman correlation analysis was carried out between the ABI value and IC risk score, and the predictive value of IC and ABI for read was evaluated by ROC analysis. Results: a total of 252 patients were included in the study, among whom 236 cases were collected simultaneously by left lower limb ABI and left lower extremity color Doppler ultrasound. There was a negative correlation between left lower extremity ABI and left lower extremity vascular color Doppler ultrasonography (P0.01r-0.186), and 238 cases of right lower extremity ABI and right lower extremity color Doppler ultrasound were collected simultaneously. There was a negative correlation between the right lower extremity ABI and the right lower extremity vascular color Doppler ultrasound abnormality (P0.01r-0.199.IC and LEAD: IC and left lower extremity color Doppler sonography results: 249 cases were positive correlation between IC value and left lower extremity vascular color Doppler ultrasound abnormality, P0.01C, right lower extremity IC and right lower extremity color ultrasound. Results there was a positive correlation between the IC value of 250 cases and the abnormal color Doppler ultrasound of the right lower extremity (0.245, P 0.01). The predicted values of IC and ABI were analyzed by ROC. The results showed that the AUC value of IC was higher than that of ABII. Conclusion: lower extremity ABI is negatively correlated with lower extremity vascular color Doppler ultrasound abnormality (P 0.01), and IC risk score is positively correlated with lower extremity vascular color Doppler ultrasound abnormality. There is a negative correlation between ABI and read risk.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.2

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 傅德良;實(shí)驗(yàn)室檢查在原發(fā)性甲狀旁腺機(jī)能亢進(jìn)癥患者中的預(yù)測(cè)價(jià)值[J];國(guó)外醫(yī)學(xué).外科學(xué)分冊(cè);2002年04期

2 鄧學(xué)軍;覃數(shù);;妊娠相關(guān)血漿蛋白A在急性冠狀動(dòng)脈綜合征中的預(yù)測(cè)價(jià)值[J];中華老年心腦血管病雜志;2008年01期

3 葉麗;張建華;徐巖;陳旭華;伍夢(mèng)佐;程自平;陳斌;;非高密度脂蛋白膽固醇水平對(duì)急性冠狀動(dòng)脈綜合征患者事件的預(yù)測(cè)價(jià)值[J];臨床心血管病雜志;2012年07期

4 孫玉發(fā);衣志勇;蔣知新;范利;李小鷹;李美芹;張波;g，

本文編號(hào)：2007178