الگوي آترواسكلروزيس شرايين اندام تحتاني در بيماران مبتلا به ديابت تحت آنژيوگرافي در بيمارستان رازي رشت در سال 5

Atherosclerotic Patterns of Lower Limb Arteries in Patients with Diabetes Mellitus Undergoing Angiography in Razi Hospital, Rasht, Iran, in 2016

ﻣﻘﺪﻣﻪ: ﻫﺪف از اﺟﺮاي اﯾﻦ ﺗﺤﻘﯿﻖ، ﺑﺮرﺳﯽ اﻟﮕﻮﻫﺎي آﺗﺮواﺳﮑﻠﺮوﺗﯿﮏ ﺷﺮﯾﺎن ﻫﺎي اﻧﺪام ﺗﺤﺘﺎﻧﯽ در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ دﯾﺎﺑﺖ آﻧﮋﯾﻮﮔﺮاﻓﯽ ﺷﺪه در ﺑﯿﻤﺎرﺳﺘﺎن رازي رﺷﺖ در ﺳﺎل 1395 ﺑﻮد. روش ﻫﺎ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ي ﻣﻘﻄﻌﯽ ﮔﺬﺷﺘﻪ ﻧﮕﺮ، ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ دﯾﺎﺑﺖ ﮐﻪ در ﺳﺎل 1395 در ﻣﺮﮐﺰ ﺟﺮاﺣﯽ اﻧﺪووﺳﮑﻮﻻر ﺑﯿﻤﺎرﺳﺘﺎن رازي رﺷﺖ آﻧﮋﯾﻮﮔﺮاﻓﯽ ﺷﺪﻧﺪ، ﺑﺮرﺳﯽ و وﯾﮋﮔﯽ ﻫﺎي دﻣﻮﮔﺮاﻓﯿﮏ، ﻋﻮاﻣﻞ ﻣﺮﺗﺒﻂ ﺑﺎ ﺑﯿﻤﺎري و ﯾﺎﻓﺘﻪ ﻫﺎي آﻧﮋﯾﻮﮔﺮاﻓﯽ ﺑﯿﻤﺎران ﺛﺒﺖ ﺷﺪ. اﻟﮕﻮي ﭘﺮوﮔﺰﯾﻤﺎل در اﯾﻦ ﻣﻄﺎﻟﻌﻪ، درﮔﯿﺮي ﻗﺎﺑﻞ ﺗﻮﺟﻪ ﺷﺮاﯾﯿﻦ ﺑﺎﻻي زاﻧﻮ و اﻟﮕﻮي دﯾﺴﺘﺎل، درﮔﯿﺮي ﻗﺎﺑﻞ ﺗﻮﺟﻪ ﺷﺮاﯾﯿﻦ زﯾﺮ زاﻧﻮ ﺗﻌﺮﯾﻒ ﺷﺪ. وﺳﻌﺖ درﮔﯿﺮي ﻋﺮوق ﺑﻪ ﮐﻤﮏ ﻣﻘﯿﺎس 2 Trans-atlantic inter-society consensus اﻧﺪازه ﮔﯿﺮي ﺷﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: 169 ﺑﯿﻤﺎر در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮرﺳﯽ ﺷﺪﻧﺪ. 60/9 درﺻﺪ ﺑﯿﻤﺎران ﻣﺮد ﺑﻮدﻧﺪ و ﻣﯿﺎﻧﮕﯿﻦ ﺳﻨﯽ ﺷﺮﮐﺖ ﮐﻨﻨﺪﮔﺎن 10/26 ± 64/34 ﺳﺎل ﺑﻮد. ﺷﮑﺎﯾﺖ اﺻﻠﯽ در 58/0 درﺻﺪ ﺑﯿﻤﺎران، زﺧﻢ ﻃﻮل ﮐﺸﯿﺪه ﺑﻮد. 47/3 درﺻﺪ اﻓﺮاد ﻣﺒﺘﻼ ﺑﻪ دﯾﺎﺑﺖ ﻣﻮرد ﻣﻄﺎﻟﻌﻪ، دﯾﺲ ﻟﯿﭙﯿﺪﻣﯽ و 65/1 درﺻﺪ ﺑﻪ ﭘﺮﻓﺸﺎري ﺧﻮن ﻣﺒﺘﻼ ﺑﻮده اﻧﺪ و 22/5 درﺻﺪ ﺑﯿﻤﺎران ﺑﻪ ﺟﺰ دﯾﺎﺑﺖ ﺑﯿﻤﺎري زﻣﯿﻨﻪ اي دﯾﮕﺮي ﻧﺪاﺷﺘﻨﺪ. 24/3 درﺻﺪ ﺑﯿﻤﺎران، ﻣﺼﺮف ﮐﻨﻨﺪه ي ﺳﯿﮕﺎر ﺑﻮدﻧﺪ. در ﻣﺠﻤﻮع، در 62/7 درﺻﺪ ﺑﯿﻤﺎران اﻟﮕﻮي آﺗﺮواﺳﮑﻠﺮوﺗﯿﮏ ﺑﻪ ﺻﻮرت دﯾﺴﺘﺎل ﺑﻮد. ارﺗﺒﺎط ﻣﻌﻨﯽ داري ﺑﯿﻦ اﻟﮕﻮي درﮔﯿﺮي آﺗﺮواﺳﮑﻠﺮوﺗﯿﮏ و ﺟﻨﺴﯿﺖ، ﺷﺎﺧﺺ ﺗﻮده ي ﺑﺪﻧﯽ، ﺳﺎﺑﻘﻪ ي ﺑﯿﻤﺎري ﮐﻠﯿﻮي و دﯾﺲ ﻟﯿﭙﯿﺪﻣﯽ ﻣﺸﺎﻫﺪه ﻧﺸﺪ. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: ﯾﺎﻓﺘﻪ ﻫﺎ ﻧﺸﺎن داد ﮐﻪ اﻟﮕﻮي درﮔﯿﺮي آﺗﺮواﺳﮑﻠﺮوﺗﯿﮏ در ﺑﯿﻤﺎران ﻣﺒﺘﻼ ﺑﻪ دﯾﺎﺑﺖ، ﺑﯿﺸﺘﺮ ﺑﻪ ﺻﻮرت دﯾﺴﺘﺎل ﺑﻮده اﺳﺖ. ﻫﻤﭽﻨﯿﻦ، ارﺗﺒﺎط ﻣﻌﻨﯽ داري ﺑﯿﻦ اﻟﮕﻮي درﮔﯿﺮي آﺗﺮواﺳﮑﻠﺮوﺗﯿﮏ و ﺟﻨﺴﯿﺖ، ﺷﺎﺧﺺ ﺗﻮده ي ﺑﺪﻧﯽ، ﺳﺎﺑﻘﻪ ي ﻣﺸﮑﻞ ﮐﻠﯿﻮي و دﯾﺲ ﻟﯿﭙﯿﺪﻣﯽ ﻣﺸﺎﻫﺪه ﻧﺸﺪ.

Background: We aimed to examine the atherosclerotic patterns of lower limb arteries in patients with diabetes mellitus undergoing angiography in Razi hospital, Rasht, Iran, in 2016. Methods: In this retrospective cross-sectional study, patients with diabetes mellitus underwent angiography in an endovascular surgery center in Razi Hospital in Rasht in 2016, were evaluated. Demographic characteristics, disease-related factors, and angiographic findings were recorded. Proximal Pattern in this study was defined as significant involvement of suprageniculate arteries, and the distal pattern was defined as significant involvement of infrageniculate arteries. The extent of vascular involvement in this study was measured by trans-atlantic inter-society consensus 2 (TASC2) scale. Findings: 169 patients were included in this study. 60.9% of the patients were men, and the average age was 64.34 ± 10.26 years. Chief complaint in 58% of the patients was non-healing ulcer (58.0%). 47.3% of the patients had dyslipidemia, 65.1% had hypertension, and 22.5% of them had no other underlying diseases. 24.3% of the patients were smokers. In general, in 62.7% of all patients, the pattern of atherosclerotic involvement was distal. There was no significant relation between atherosclerotic involvement pattern and sex, body mass index (BMI) range, history of renal disease, or dyslipidemia. Conclusion: The findings showed that the most prevalent pattern of atherosclerotic vascular involvement in patients with diabetes mellitus was distal pattern. There was no significant relationship between atherosclerotic pattern and sex, BMI, history of renal disease, and dyslipidemia