超声定量技术及Sono CT在2型糖尿病颈动脉病变中的应用

The application of QLAB and sono CT in the vascular pathology of carotical artery in patients with type2 DM

目的:探讨超声内-中膜自动测量技术(QLAB)和实时复合成像(Sono CT)对2型糖尿病颈动脉病变检测的价值。方法:对124例2型糖尿病患者及82例对照组的颈动脉分别进行检测,观察颈动脉后壁内-中膜厚度(IMT)、有无斑块形成,并根据是否伴有高血压及病程长短分组,将结果进行比较分析。结果:糖尿病各组IMT增厚共101例(81.5%),检出斑块96例(78.2%),对照组IMT增厚33例(40.2%),检出斑块26例(31.7%)。两组比较有显著性差异(P<0.05)。糖尿病合并高血压组斑块检出率高于无高血压组,经QLAB测量的IMTmean>无高血压组,结果有显著性差异(P<0.05)。糖尿病病程>5年者斑块检出率高于病程≤5年者,IMT厚度大于病程≤5年者厚度,结果有显著性差异(P<0.05)。结论:2型糖尿病患者颈动脉病变以IMT增厚为主,其次是斑块形成。SonoCT技术可使颈部血管细微结构的分辨率提高,增加血管病变边界的可见度,QLAB测定颈动脉内膜平均厚度较最厚值更具优越性,对糖尿病血管病变的早期诊断及指导治疗具有重要价值。

Objective：To explore the value of intima-media thickness quantification technology and Sono CT in evaluating the vas-cular pathology of carotid artery in patients with type 2 diabetes mellitus.Methods： The carotid artery of 124 patients with type 2 diabetes mellitus and 82 healthy controls were detected respectively.The IMT of the the posterior wall of the carotid artery,and the presence of atherosclerotic plaque were observed.The patients were divided into DM1 group and DM2 group according to with or without hypertention,and the course of disease.Results： In DM1 with hypertention and DM2 without hypertention,the prevalence rates of carotid IMT are 81.5%,rates of carotid plaque are 78.2%,while in control group the data were 40.2% and 31.7%.There was significant difference between the two groups（P 〈 0.05）.The prevalence rates of carotid plaque of DM2 are higher than DM1,mean carotid IMT of DM2 which detected by QLAB are higher than that of DM1,with highly significant difference.The preva-lence rates of carotid IMT and carotid plaque of patients with more than 5 years course of disease are higher than those patients with less than 5 years.Conclusion： The main change of carotid lesions in type 2 diabetes mellitus is the carotid IMT.The second change is carotid plaque.Sono CT technology can improve the resolution capability of the fine structure,increase the visibility of the rim of vascular lesions.The mean IMT measured by QLAB is superior to the maximum IMT in evaluating the vascular pathology of carotid artery in diabetes patients.It is especially valuable for the early diagnosis and guidance treatment of type 2 diabetes mellitus.