超声评价糖尿病患者颈、股动脉内-中膜厚度及斑块与冠心病相关性的研究

Thy Study of Intima-media Thickness and Plaque of Carotid,Femoral artery and Their Correlations in Diabetic Patients with Coronary Heart Disease

目的探讨2型糖尿病病人颈动脉(CA)、股动脉(FA)的结构变化及其间相关性的研究。寻找2型糖尿病病人并发冠状动脉硬化的早期证据,为临床提供有效的观察方法和指标。方法分别测定了30例2型糖尿病合并冠心病(1型)、30例2型糖尿病无合并症者(2型)及30例正常对照组的外周动脉内中膜厚度(IMT)及动脉硬化斑块。结果糖尿病人的颈动脉、股动脉出现不同程度的内膜增厚及斑块形成;糖尿病合并冠心病(CAD)组与无合并症组颈动脉、股动脉的内-中膜增厚及斑块发生率均明显高于对照组(P<0.01),合并冠心病组颈动脉、股动脉的内-中膜增厚高于无合并症组(P<0.01);合并冠心病组股动脉的斑块发生率与无合并症组比较有显著差异(P<0.05)。颈动脉、股动脉粥样硬化与冠状动脉粥样硬化之间有着密切联系且股动脉粥样硬化斑块对冠心病的诊断的敏感性更高。结论外周动脉粥样硬化是糖尿病靶器官损害的标志之一,彩色多普勒超声能评价外周动脉病变的程度,临床上具有重要的实用价值。

Objective To investigate the structural changes of carotid, femoral artery in type Ⅱ diabetes mellitus patients and the correlation between two examination, to probe into the clinical value of high - resolution ultrasound on the early detection of coronary atherosclerosis in patients with type 2 diabetes mellitus. Methods The carotid IMT and plaque were measured in 30 type Ⅱ diabetes mellitus patients with coronary atherosclerotic disease （ group Ⅰ ） , 30 type Ⅱdiabetes mellitus patients without complication （ group Ⅱ ） and 20 normal cases. Result In the patient group, arterial wall became thick and rough and the atherosclerotic plaques were found inside vascu- lar cavities; The IMT and plaque incidence of CA and FA with CAD or without complication were all greater than those of the control group （P 〈 0.01 ） ; The IMT of patient with CAD was higher than those of without complication （ P 〈 0.01 ） ; The plaque incidence of FA with CAD was higher than that of without complication（P 〈 0.05 ）. There is closely relationship between CA,FA and coronary artery, the FA atherosclerosis plaque is more sensitive to the diagnose of CAD. Conclusion Carotid atherosclerosis is one of the target organ damage signs in diabetic patients, Color Doppler can reflect the severity of atherosclerosis, and it is valuable in the clinical application.