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題名 | Prevalence, Risk Factors and Associated Cardiovascular Complications of Peripheral Arterical Disease in Type 2 Diabetic Patients in Eastern Taiwan=東臺灣第2型糖尿病患罹患周邊血管疾病的盛行率、危險因子與相關血管併發症 |
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作者 | 傅振宗; 張比嵩; 裴馰; 郭熙文; 李原傑; 李哲全; 吳篤安; | 書刊名 | 慈濟醫學 |
卷期 | 18:4 民95.08 |
頁次 | 頁275-282+329 |
分類號 | 415.6681 |
關鍵詞 | 微蛋白尿; 周邊血管疾病; 糖尿病; Albuminuria; Peripheral arterial disease; Diabetic mellitus; |
語文 | 英文(English) |
中文摘要 | 目的:探討第2型糖尿病患罹患周邊血管疾病的危險因子與相關的血管併發症。材料與方法:我們在東臺灣某醫學中心的糖尿病門診選取40歲以上的第2型糖尿病患,除了收集病患的基本資料外,並安排眼底、生化及周自邊血管超音波檢查,其中,生化檢查包括空腹血糖、血脂肪、尿酸、糖化血色素和微蛋白尿,周邊血管疾病的診斷是病患下肢的ABI值<0.9。結果:總共有309位病患參加,其中的38位罹患周邊血管疾病(盛行率:12.3%,男性:12.7%,女性:11.9%)。合併周邊血管疾病的病患中92.1%有高血壓,15.8%有中風,13.2%有冠心症,47.4%有微蛋白尿,41.9%有視網膜病變(257位接受眼底檢查)。單變項分析顯示和周邊血管病變有關的因素包括年齡、抽菸、高血壓、腦中風、糖尿病罹患時間長短、使用胰島素治療與瞰蛋白尿。多變項分析顯示年齡是罹患周邊血管疾病的最重要因素,病人每增加一歲,危險性就增加1.11位;其次是抽菸,有抽菸的病患危險性是沒抽菸的4.77位;有蛋白尿的病患危險性較高;此外,是否有接受胰島素治療也是相關因素。結論:第2型糖連病患罹患周邊血管的相關因素包括病患年齡,抽菸,使用胰島素治療與是否有微蛋白尿,建議在臨床診療中應包括微蛋白尿評估與戒菸課程。 |
英文摘要 | Objective: The purpose of this study was to evaluate the risk factors, including albuminuria, for peripheral arterial disease (PAD), and associated complications in patients with type 2 diabetes. Materials and Methods: All patients with type 2 diabetes 40 years old and over, were recruited consecutively from diabetic clinics at a medical center inestern Taiwan. Information regarding each participant’s sociodemographic characteristics and medical history was gathered from the patients and their medical records. A clinical examination which included anthropometric measurements and a direct ophthalmoscope check-up was performed. After an overnight fast, serum lipids, uric acid, fasting plasma sugar, A1C and urinary albumin concentration were measured. The ankle-brachial index (ABI) was calculated by Doppler examination in both legs. PAD was diagnosed if the ABI in one of the legs was less than 0.9. Results: A total of 309 patients were recruited. PAD was present in 38 oif the 309 diabetic subjects studied (12.3%; 12.7% of the men and 11.9% of the women). Of all subjects with PAD, 92.1% had a history of hypertension, 15.8% had stroke, 13.2% had coronary heart disease, and 47.4% had albuminuriaq. For those who completed the direct ophthalmoscope examination. 41.9% of patients with PAD had diabetic retinopathy. In univariate analysis, the significant associative risk factors for PAD were age, tobacco smoking, history of hypertension/stroke, duration of diabetes, insulin therapy, usage of angiotension-converting enzyme inhibitors/ angiotension-receptor blockers (ACEI/ARB) and albuminuria. Multiple logistic regression analysis identified age as the most significant risk factor for PAD. The higher the age of the patient, the greater the likelihood of PAD, with a 1.11-fold increase in risk incurred for every 1-year increment. Cigarette smoking was also a significant factor with smokers incurring a 4.77-fold higher risk than non-smokers. Individuals suffering from macroalbuminuria were more likely to have PAD compared to those without albuminuria. Other significant risk factors included insulin usage. Conclusion: The occurrence of Pad in type 2 diabetic patients is associated with the age of the patient, smoking insulin usage and albuminruia. Incorporation of albuminuria assessment and a smoking-cessation programs are recommended in clinical practice. |
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