DOI: 10.66106/xnabba.20250202 ISSN: 3105-6679

老年糖尿病下肢血管病变的筛查与防治策略研究（Screening and Prevention Strategies for Lower Extremity Vascular Disease in Elderly Patients with Diabetes）

裴静芳 Jingfang Pei
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Abstract：To investigate the epidemiological characteristics, screening strategies, and comprehensive prevention and treatmentpathways for lower extremity arterial disease (LEAD) in elderly patients (≥65 years) with diabetes, and to provide a theoretical basisfor constructing an integrated hospital-community-family health management model. Based on the "Chinese Guideline for the Man-agement of Diabetes Mellitus in the Elderly (2024 edition)", the "Chinese Expert Consensus on Panvascular Disease Risk Assessmentand Management in Type 2 Diabetic Patients (2022 edition)", and data from the China DiaLEAD study, the prevalence, risk factors,and screening methods (ankle-brachial index, color Doppler ultrasound, etc.) of LEAD in elderly diabetic patients were systematical- ly analyzed, and a comprehensive intervention plan centered on health management was proposed. There are approximately 35.5 mil-lion elderly diabetic patients (≥65 years) in China. The prevalence of LEAD increases with age and disease duration, reaching 21.2%in type 2 diabetic patients over 50 years old. An ABI ≤0.9 is a key diagnostic indicator for LEAD. Combining symptom assessment(intermittent claudication, rest pain) and imaging examinations can improve early detection rates. Comprehensive management in-cludes lifestyle interventions (smoking cessation, exercise), control of blood glucose, blood pressure, and lipids, antiplatelet therapy,and revascularization. Health management can significantly improve patients' ABI indicators and quality of life. The prevention andtreatment of LEAD in elderly diabetic patients should establish a closed-loop system of “screening-assessment-intervention-fol-low-up”and reduce the risk of amputation and cardiovascular events through multidisciplinary collaboration (endocrinology, vascularsurgery, health management).

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