2型糖尿病患者脉搏波传导速度、踝臂指数和颈动脉粥样硬化的相关性研究

A correlation analysis on the pulse wave velocity, ankle-brachial index and carotid atherosclerosis in type-2 diabetes

目的探讨2型糖尿病人群大动脉顺应性和颈动脉粥样硬化的情况及相关性。方法随机抽取我院2型糖尿病患者以及正常对照各80例作为研究对象。使用动脉硬化诊断装置VP-1000检测肱踝脉搏波传导速度（BaPWV）和踝臂指数（ABI），采用多普勒彩色超声观察颈总动脉内膜-中层厚度（IMT）以及斑块形成情况，比较两组合并颈动脉斑块时脉搏波传导速度的变化情况，分析颈动脉IMT与BaPWV和ABI的相关性。结果糖尿病组BaPWV[（1752±213）cm／s]较正常对照组[（1279±159）cm／s]升高（t=28．09，P〈0．01）；糖尿病组ABI（0．95±0．13）与正常对照组（1．28±0．17）相比差异有统计学意义（t=32．11，P〈0．01）。糖尿病组颈动脉IMT增厚率（45．0％）及斑块发生率（35．0％）与正常对照组（分别为27．5％和10．8％）相比差异有统计学意义（x2值分别为4：16、4．14，P均〈0．01）；糖尿病组合并颈动脉斑块者BaPWV[（1810±296）cm／s]较无颈动脉斑块[（1480±304）cm／s]者升高（t=15．86，P〈0．01）。糖尿病患者BaPWV与颈总动脉IMT呈正相关（r=0．271，P〈0．05），ABI与IMT呈负相关（r=-0．406，P〈0．05）。结论BaPWV与糖尿病患者颈动脉IMT呈正相关，ABI与IMT呈负相关，BaPWV和ABI可作为评估糖尿病外周动脉硬化情况有效且简便易行的指标。

Objective To investigate the correlation of arterial compliance and carotid atherosclerosis in patients with type-2 diabetes. Methods Eighty eases of type-2 diabetic patients and 80 control subjects were recruited into the study. Brachial-ankle pulse wave velocity （BaPWV） and ankle-brachial index （ABI） were measured with atherosclerosis diagnostic devices VP-1000. The inner-membrane and medium-membrane thickness （IMT） of the common carotid artery and plaque were detected with color Doppler uhrasound. The difference of the pulse wave velocity in the subjects with carotid plaques were compared between the two groups. The correlations of carotid IMT with BaPWV and ABI were also analyzed. Results In the diabetic patients group,BaPWV （ [ 1752 ± 213] crn/s） was higher than that of normal control group （ [ 1279 ± 159] crn/s） （P 〈0. 01 ） ;ABI in diabetic patients group （0. 95 ±0. 13）was lower than that of control group （1.28 ± 0. 17）, （ P 〈 0. 01 ）. In the diabetic patients group, the incidences of carotid IMT thickening （ 45.0% ） and plaques （35.0%）were both higher than that of control group （27.5% and 10. 8% ,respectively） （P 〈0. 05）. In the diabetic patients group,the cases with carotid plaques had a higher BaPWV （[ 1810 ± 296] cm/s） than those without （ [ 1480 ± 304 ] cm/s ） （ P 〈 0. 01）. BaPWV was positively correlated with carotid IMT （ r = 0. 271, P 〈 0. 05）. ABI and IMT was negatively correlated （ r = - 0. 406,P 〈 0. 05）. Conclusion BaPWV and carotid IMT was positively correlated, while ABI and IMT was negatively correlated. BaPWV and ABI are indicators which are practicable and effective to evaluate the stiffness of peripheral arteries in patients with diabetes.