不同超声手段在2型糖尿病患者足背动脉病变检测中的应用

Clinical Value of Ultrasonography in the Detection of Dorsalis Pedis Artery Lesion in Type 2 Diabetic Patients

【目的】探讨超声检测糖尿病患者足背动脉的临床价值。【方法】用彩色超声分别检测50例2型糖尿病患者及50例对照组的足背动脉。根据病程分为两组：病程〈10年为Ⅰ组；病程≥10年为Ⅱ组。根据入院时RPG分为两组：RPG〈15mmol／L为A组；RPG≥15mmol／L为B组。二雏超声观察足背动脉血管走行、管壁回声强度、内膜光滑程度、管腔内径、管壁厚度。CDFI观察腔内彩色血流信号状态，PW测量Vs、Vd、RI、PI。【结果】正常对照组足背动脉内膜呈平行的细线状强回声，内壁光滑不厚、连续性好。CDFI显示血流充盈良好，PW显示三相血流频谱，频带较窄。2型糖尿痛组足背动脉管壁增厚，呈点状不均匀强回声，内膜毛糙，部分可见斑块附着，管腔变窄，连续性差，走行迂曲。CDFI显示管腔内彩色血流变细，充盈缺损以及无彩色血流显示，PW呈双相波，频带宽，少数为三相波。糖尿病患者足背动脉血流速度减慢，Vs及Vd均较正常人降低（P〈0．05），RI、PI增高（P〈0．01）。不同病程组（Vs：27．9±9．71vs2b．9±8．71；Vd：10．2±3．21vs7．56±3．46；RI：1．11±0．19vs1．29±0．26；PI：2．50±0．40vs2．90±0．45）与血糖组（Vs：27．0±10．5vs21．3±8．15；Vd：10．4±2．97vs7．64±2．84；RI：1．09±0．27vs1．30±0．26；PI：2．51±0．38vs2．89±0．45）比较，其差异也具有统计学意义（P〈0．05）。【结论】超声能够客观准确地反映2型糖尿病患者足背动脉随着病程的延长及血糖的升高在病理方面的改变，CDFI能准确地反映足背动脉的损伤程度及在血流动力学方面的改变，尤其为早期无症状的病人提供了较可靠的诊断数据。

[Objective]To study the clinical value of ultrasonography in the detection of dorsalis pedis artery lesion in type 2 diabetic patients. [Methods] Dorsalis pedis arteries in 50 healthy adults and 50 patients with type 2 diabetes mellitus were detected by color Doppler ultrasonography. The patients were divided into two groups according to the duration of the disease and the RPG. The Vs, Vd, RI and PI were analyzed between the groups. [Results] In the normal control group, dorsalis pedis artery wall was smooth, thin and consecutive. The Vs and Vd of dorsalis pedis artery in type 2 diabetic patient were significantly reduced than those in healthy adults （ P 〈0.05）. And the PI and RI were significantly increased （ P 〈0.05）. [Conclusion]Ultrasound examination is valuable in the evaluation of the diabetes, especially at the early stage of artery diseases in asymptomatic patients. It＇ can provide a more reliable diagnostic data for early asymptomatic patients.