糖尿病及其合并高脂血症对颈部动脉粥样硬化影响的超声研究

Effect of diabetes and diabetes associated with hyperlipiodemia on atherosclerosis of carotid and vertebral arteries

目的 应用超声评价糖尿病及其合并高脂血症时对颈部动脉粥样硬化的影响。方法 对 2 型糖尿病(DM)33例,糖尿病合并高脂血症(DH)58例及对照组40例进行颈部动脉超声检查,分别测量颈动脉的内 中膜厚度(IMT),计算斑块检出率及两侧颈部动脉的血流动力学指标。结果 DM和DH组的 IMT均高于对照组,其中DH组最高。斑块检出率:DM和DH组分别为48.5%和50%高于对照组(25%)。DM和DH组的PSV/EDV和血流量降低,PI和RI增高。血糖和血脂分别与IMT、RI和PI值呈正相关。结论 糖尿病合并高脂血症可加重颈部动脉粥样硬化的程度,致血管弹性降低、阻力升高。

Objective To investigate the effect of diabetes and diabetes associated with hyperlipiodemia on the atherosclerosis of carotid and vertebral arteries using color Doppler ultrasonography. Methods A total of 131 cases included 33 diabetes patients(DM), 58 diabetes associated with hyperlipiodemia patients (DH) and 40 control subjects underwent color Doppler ultrasonography. Intima-media thickness (IMT) in common carotid artery (CCA-IMT) and its bifurcation (BIMT), plaque and hemodynamic indices were respectively measured in common carotid artery and its bifurcation, internal carotid artery and vertebral artery. Results The IMT was higher in DM and DH groups than that in the control group, with the highest in DH among the three groups. The incidences of carotid plaque in DM, DH and control group were 48.0%, 50.0% and 25%, respectively. Compared with the control group, the PSV/EDV and volume were lower, and the pulsatility index (PI) and resistance index (RI) were higher in DM and DH groups. There were positive relations between the level of the blood sugar and lipid in serum and Intima-media thickness, PI and RI. Conclusion Diabetes associated with hyperlipiodemia would make atherosclerosis, and lead to a lower vascular stretch and a higher vascular resistance.