经颅多普勒对2型糖尿病患者脑血管病变的评估价值

Evaluation of cerebrovascular function using transcranial Doppler in type 2 diabetes

目的探讨经颅多普勒(TCD)检测2型糖尿病脑血管早期病变的临床应用价值。方法将60例2型糖尿病无微血管病变临床症状的患者分为A组(病程≥10年)、B组(病程<10年),与年龄相近的30例对照组(C组)接受经颅多普勒(TCD)检查,对比分析各组人群大脑中动脉(MCA)、颈内动脉(ICA)末段、大脑前动脉(ACA)、基底动脉(BA)的平均血流速度、搏动指数(PI)及频谱图像的差异。结果 A组、B组患者与C组间平均血流速度比较显著升高(P均<0.01),PI基底动脉A组与B组间无显著差异(P>0.05),其余A组、B组患者和C组间脑动脉的PI值均显著升高(P<0.01);糖尿病组(A组+B组)脑血管硬化较C组明显(P<0.05),脑血管异常也较C组明显(P<0.01)。结论 TCD检测无症状2型糖尿病脑血管病变具有良好的敏感性,可以为及时制定干预治疗措施提供依据。

Objective To evaluate the diagnostic value of transcranial Doppler （TCD） in cerebrovascular disease of type 2 diabetes mellitus. Methods A total of 60 type 2 diabetes patients and 30 health control subjects were enrolled in the study. Patients were divided into two groups：group A with long-term（ course of disease ≥ 10 years） diabetes and group B with short-term（ course of disease 〈 10 years） diabetes. Mean blood-flow velocity and pulsatility index （PI） in the middle cerebral artery （ MCA ）, internal carotid artery（ICA） , anterior cerebral artery （ACA）, basilar artery （BA） were measured with a transcranial Doppler probe and the frequency spectrogram were calculated. Results Average blood velocity relatively in both group A and group B were significantly higher than that in C group （ P all 〈0.01 ） ;PI of BA between A group and B group didn＇t show significant difference （ P 〉 0.05 ） ; the PI value of brain artery showed remarkable difference among group A, group B and group C （P 〈 0.01 ）;cerebral vessel hardening and abnormity of the groups（group A ＋ group B） of the diabetes were more apparent than those of the group C （P 〈 0.05）. Conclusion TCD is sensitive in the test of non-symptomatic cerebrovascular disease of type 2 diabetes, and can provide evidence for timely preventive measures for clinic.