彩色多普勒超声对2型糖尿病患者下肢动脉病变的诊断价值

The diagnosis value of color Doppler ultrasound for type 2 diabetes mellitus patients with lower extremity artery pathology

目的探讨2型糖尿病(DM)患者下肢动脉病变的彩色多普勒超声诊断价值。方法选择70例确诊为2型DM患者和50例正常对照组进行下肢动脉彩色多普勒超声检查,测量内-中膜(IMT)厚度、粥样硬化斑块、管腔狭窄部位、管腔闭塞部位及血流动力学情况。结果①DM组IMT较对照组明显增厚(P<0.01),异常血流和闭塞检出率较对照组高(P<0.01)。②2型DM组下肢动脉硬化斑块检出率明显高于对照组(P<0.05)。③有下肢症状组动脉明显狭窄和闭塞检出率较无症状组高(P<0.01)。结论二维声像图可清晰显示2型DM患者下肢动脉IMT和斑块,结合彩色多普勒血流显像(CDFI)及频谱检测可判断下肢病变部位、范围、程度和管腔闭塞,并且对早期无症状糖尿病下肢病变能提供可靠依据,具有重要的临床应用价值。

Objective To probe the diagnosis value of color Doppler ultrasound for type 2 diabetes mellitus （DM） patients with lower extremity artery pathology. Methods 70 cases of type 2 diabetes millitus were selected in the study and 50 healthy subjects were elected as a control group. The color Doppler ultrasound was performed for patients with lower extremity arteries. The internal - medial membrane （IMT） thickness, the size of the hardened spots, and the stricture extent of the vessel cavity, vessel cavity blockage position and the hydrodynamics of blood flow were measured. Results （1） IMT of DM group was thinker than that of control group （ P 〈 0.01 ）, positive rate of abnormal blood current was higher than that of control group （ P 〈 0.01 ）. （2） The detection rate of vessel hardened spots in lower extremities blood were higher in type 2 DM group than that of control group （ P 〈 0.05 ）. （3）The detection rate of vessel stricture and blockage was higher in group with the lower extremities symptoms than that of the group with no symptoms （ P 〈 0.01 ）. Conclusion Two dimensional ultrasound clearly displays IMT and spots of type 2 DM patients. The extremity vessel and pathology position, scope, degree and cavity blockage can be determined by combination of two dimensional ultrasound and color Doppler flow image.