股动脉内-中膜厚度、僵硬度及血流动力学参数评价2型糖尿病患者下肢血管病变

Clinical evaluation of peripheral vascular disease with wall thickness,stiffness and hemodynamics of femoral artery in type 2 diabetes mellitus

目的探讨股动脉内-中膜厚度(FA-IMT)、僵硬度β及血流动力学参数与2型糖尿病患者下肢血管病变(PVD)的相关性。方法151例2型糖尿病患者分为PVD症状组(具有间歇性跛行和(或)静息性腿痛)和无PVD症状组。使用二维超声测量FA-IMT;彩色流速流量定量技术测量股动脉收缩期内径及舒张期内径,收缩期峰值血流速度(PSV)和舒张末期血流速度(EDV)。比较FA-IMT、股动脉僵硬度β(FA-stiffnessβ)、PSV、EDV在两组中的差异,多元回归分析FA-IMT、FA-stiffnessβ、PSV、EDV与PVD症状的相关性。结果与无PVD症状组比较,PVD症状组FA-IMT、FA-stiffnessβ增高(P<0.01),PSV、EDV减低(P<0.01)。PVD症状组中,FA-IMT与FA-stiffnessβ无相关性(P=0.10);病程、FA-stiffnessβ,PSV,EDV和下肢PVD症状相关;而年龄,性别、FA-IMT及与PVD症状无相关性。结论FA-stiffnessβ在2型糖尿病患者PVD的临床评价中发挥着更重要作用。

Objective To evaluate the relationship between femoral artery intima media thickness （FA-IMT）, stiffness, bemodynamics factors of femoral artery and peripheral vascular disease （PVD） in type 2 diabetes mellitus. Methods According to the presence of PVD, 151 patients with type 2 diabetes were divided into PVD group and non PVD group. FA-IMT was tested with 2D ultrasound. Ds, Dd, PSV, EDV were observed with color flow rate and volume quantitative technology. FA-IMT, FA-stiffness β, peak systolic velocity （PSV） and end diastolic velocity （EDV） were compared between the two groups. Results Compared with non-PVD group, FA-IMT and FA-stiffness β increased in PVD group （P〈0.01）, whereas PSV and EDV decreased in PVD group （P〈0.01）. There was no relationship between FA stiffness β and FA-IMT in PVD group （P〈0.01）. Multiple Logistic regression indicated the presence of PVD symptoms associated closely with FA- stiffness β, PSV, EDV and duration of diabetes. Conclusion Stiffness β plays an important role in the clinical evaluation of type 2 diabetes mellitus.