彩色脉冲多普勒超声对2型糖尿病下肢血管病变的评估价值

The evaluation of peripheral arterial disease by color and pulsed Doppler ultrasound in type 2 diabetic patients

目的应用彩色脉冲多普勒超声检查观察2型糖尿病(DM)下肢血管病变的血流异常改变,探讨其对2型DM下肢血管病变的评估价值。方法A组为2型DM并下肢血管病变患者65例,B组为单纯2型DM患者60例,C组为健康对照组30例。所有研究对象均检测生化指标;对下肢血管均做彩色脉冲多普勒检查,观察频谱形态,测定峰值流速(Vmax)、平均血流速度(Vmean),测定四肢血压,计算踝肱指数(ABI)。结果(1)A组病程、血清总胆固醇、载脂蛋白B与B组比较有显著性差异(P<0.01,P<0.05);(2)A组ABI明显减低,与B、C组比较有显著性差异(P<0.01);A、B组Vmax明显增高,与C组比较有显著性差异(P<0.01,P<0.05);(3)ABI与年龄、病程呈负相关(P<0.05,P<0.01)。结论(1)2型DM较正常人易发生下肢血管病变,并随病程延长而加重。(2)2型DM下肢血管病变时,ABI、Vmax是评估病情程度的重要指标。(3)彩色脉冲多普勒对诊断2型DM下肢血管病变、预防下肢坏疽发生具有重要的临床价值。

Objective To observe the abnormal changes of peripheral arterial disease （PAD） and blood flow by using color and pulsed Doppler ultrasound examination in patients with type 2 diabetes, and investigate the significance of color and pulsed Doppler ultrasound examination in the diagnosis with PAD.Methods All cases were divided into the group A （65 cases with PAD） , group B （60 cases was without PAD） and C（30 normal control group）. Serum marker was measured. The dorsal artery of foot of lower limbs were tested with color and pulsed Doppler ultrasound examination to observe the spectral form. The Vmax, V and ABI were determined. Results （1）The duration of diabetes , TC and APOB were significantly increased in A compared with B（ P 〈0.01）. （2）The ABI in A were lower than those B and C（ P 〈0.05, P 〈 0.01）. The Vmax in A and B were higher than those in C（ P 〈0.05, P 〈 0.01） （3）The ABI was significant correlation with age and duration of diabetes（ P 〈 0.01）. Conclusion （1） Atherosclerosis occurs is higher in patients with type 2 diabetes, and it aggravates with disease course. （2）The changes of ABI and Vmax is the most severe by using color and pulsed Doppler ultrasound examination in the diabetic angioplasty of lower limbs. （3）The color and pulsed Doppler ultrasound examination is of important clinical significance for the diagnosis of diabetic angioplasty of lower limbs and preventing the occurrence of lower limbs＇ gangrene in patients with type 2 diabetes.