糖尿病患者颈动脉结构、功能及血流动力学的变化

Changes of Structure,Function and Hemodynamics of Carotid Artery in Diabetic Patients

目的应用高频超声评估糖尿病(DM)患者颈动脉结构、功能及血流动力学的变化,为糖尿病颈动脉粥样硬化的早期诊断及防治提供一项有效的方法。方法选择32例糖尿病患者,分为糖尿病无高血压组(n=16)及糖尿病合并高血压组(n=16),选择14例正常人作对照组,应用高频超声测量计算各组研究对象的颈动脉内中膜复合体厚度(IMT)、弹性指数(Ep)、僵硬指数(β)、收缩期峰值血流速度(Vs)、舒张末期血流速度(Vd)、阻力指数(RI)。结果糖尿病患者颈动脉斑块检出率较高,正常对照组未发现斑块。糖尿病各组颈动脉IMT增厚,僵硬参数Ep、β升高,分别与对照组比较,均具有极显著的统计学意义(P<0.01)。与对照组相比,糖尿病各组颈动脉收缩期峰值流速、舒张末期流速减低,阻力指数增高。结论糖尿病患者颈动脉内中膜复合体增厚,动脉僵硬度增加,颈动脉收缩期峰值流速、舒张末期流速减低,阻力指数增高。因此应用高频超声有助于早期发现颈动脉粥样硬化。

Objective：Using high resolution ultrasonography to evaluate the changes of structure,function and hemodynamics of carotid artery in diabetic patients, to provide an effective and helpful information for early diagnosis as well as preventive treatment for diabetes-complicated arteriosclerosis of carotid artery. Methods：Thirty-two patients with diabetes mellitus （without and with .hypertension for 16 patients each） and fourteen normal volunteers were included in this study. Parameters including intimal .media thickness （IMT）, peak systolic velocity （Vs）,end diastolic velocity （Vd） and resistance index （R]） of carotid artery were measured. Elastic modulus （Ep） and stiffness index （β） were calculated. Results：The frequency of detecting arteriosclerosis was higher in diabetic patients. No arteriosclerotic plaque within carotid artery was found in the control group. Compared with the control group,]MT, Ep and ~ were increased in each of the two diabetic group with significant diffderence statiscally （P〈0.01）. Also, the Vs and Vd of carotid artery were lower and the RI of carotid artery was higher in each of the diabetic group. Conclusion：In diabetic patients,IMT,Ep and β of carotid artery were increased,Vs and Vd decreased,and the RI increased. High resolution ultrasonography plays an important role in the early diagnosis of carotid atherosclerosis.