糖尿病足患者足背动脉超声检测与血液流变学的相关性研究

A study on the relationship between ultrasonography of dorsalis pedis artery and hemorheology in patients with diabetic foot

目的探讨糖尿病足患者足背动脉超声检测指标与血液流变学之间的相关性。方法51例糖尿病足患者根据肢端有无开放性溃疡分为溃疡组(23例)和无溃疡组(28例),对足背动脉的超声测量参数与血液流变学指标进行多元相关回归分析。结果溃疡组血管内径(D)、收缩期峰值流速(PSV)、阻力指数(RI)、搏动指数(PI)低于无溃疡组,而高切变率全血黏度(BVH)、低切变率全血黏度(BVL)、血浆黏度(PV)、纤维蛋白原(Fib)高于无溃疡组。多元相关回归分析显示BVH、BVL能对D产生影响,偏回归系数(r)分别为-0.004和-0.009;PSV与BVH、PV关系密切,r分别为-0.957、-25.655;而RI与BVH,PI与BVH、PV、Fib关系较密切,r分别为-0.009、-0.141、-2.666、-0.383。结论血液流变学改变可以加重糖尿病足患者下肢小血管的血流动力学异常和血管病变程度,是加剧肢端局部缺血引起糖尿病足溃疡的因素之一。

Objective To study the relationship between ultrasonography of arteria dorsalis pedis and Hemorheology in patient with diabetic foot. Methods According to with or without frank anabrosis, 51 patients were derided into two sub-groups： anabrosis group （23 patients） and no-anabrosis group （28 patients）. The correlativity was analysed between the parameters of ultrasonography in arteria dorsalis pedis and hemorheological indices on patients with diabetic foot. Results When compared to patients without ulcers, vascular inner diameter （D）, peak systolic velocity （PSV）, resistent index （RI） and pulsatility index （PI） on patients with frank anabrosis were decreased significantly, but whole blood viscosity at high shear rate （BVH）, whole blood viscosity at low shear rate （BVL）, plasma viscosity （PV）, fibrinogen （Fib） were increased. Multiple regression analyses indicated that the relationship between BVH, BVL and D was presence, partial regression coefficient （r） was -0.004 and -0.009; the relationship between PSV and BVH, PV was intimate, r was -0.957 and -25.655; the relationship between RI and BVH, PI and BVH, PV, Fib were relatively intimate, r was -0.009, -0.141, -2.666, -0.383, respectively. Conclusions The changes of hemorheology can aggravate the abnormality of hemodynamics and the degree of vascular lesion in small vessels of lower limb, so it is one of influencing factor leading to lower limb arterial ischaemia and diabetic foot deterioration.