应用血管回声跟踪技术对糖尿病视网膜病变患者颈动脉弹性的临床研究

A clinical study on carotid elasticity in diabetic retinopathy patients by E-Tracking technique

目的:运用E-Tracking技术检测糖尿病视网膜病变患者的颈动脉弹性。方法:选择2型糖尿病患者90例及健康志愿者30例,测量颈动脉收缩期内径(Ds)、血管内膜中层厚度(IMT)、收缩期峰值流速(PSV)、阻力指数(RI)、压力-应变弹性系数(Ep)、硬化参数(β)、顺应性(AC)、单点脉搏波传导速度(PWVβ)、增大指数(AI)。结果:①与对照组比较,糖尿病A组、B组、C组Ds、PSV、RI无明显差异,糖尿病A组IMT无显著性差异;糖尿病B组IMT有显著性差异(P<0.05);糖尿病C组IMT有显著性差异(P<0.01);②与对照组比较,糖尿病A组Ep、β测值均明显高于对照组(P<0.01),PWVβ、AI高于对照组(P<0.05);AC测值低于对照组(P<0.05)。糖尿病各组间Ep、β、PWVβ、AC测值有统计学差异(P<0.05),AI无统计学差异。结论:2型糖尿病患者颈动脉在发生动脉硬化形态学改变之前,其血管内皮功能已存在损伤,糖尿病视网膜病变患者颈动脉弹性减低更为明显。

Objective： To detect carotid elasticity in patients with diabetic retinopathy by E-Tracking technique. Methods： Ninety patients of type 2 diabetes and 30 healthy volunteers were recruited in the study. The systolic diameter of the carotid artery（Ds）, thickness of intima media（IMT）, peak systolic velocity（PSV）, resistance index（RI）, pressure strain elastic modulus（Ep）, stiffness parameter（β）, arterial compliance（AC）, pulse wave conducting velocity（PWVβ）, augmentation index（AI） were evaluated. Results： （1）The Ds, PSV, RI of group A, B, C were not obviously different from those of the control group. The IMT of group B and C was statistically different from that of the control group （P〈0.05 and P〈0.01）. （2）Ep, β, PWVβ and AI of group A were higher than those of the control group（P〈0.01 for Ep and β, P〈0.05 for PWVβ and AI）; AC of group A was lower than that of the control group（P〈0.05）. Statistic difference of the Ep, β, PWVβ, AC existed among different diabetic groups（P〈0.05）. Conclusion： In patients with type 2 diabetes, damage of endothelium function already exists before the morphology changes of sclerosis observed in carotid artery. The elasticity of carotid artery decreases more obviously in patients with diabetic retinopathy.