二维血流显像技术及多普勒超声对2型糖尿病早期下肢血管内皮功能状况研究

Study of endothelial function of lower extremity vessels in patients with type 2 diabetes by B-Flow and Doppler ultrasound

目的应用二维血流显像技术(B-Flow)及多普勒超声技术检测2型糖尿病患者下肢动脉血管内皮功能的状况并探讨其影响因素。方法对2型糖尿病无并发症患者(Ⅰ组)与2型糖尿病有并发症患者(Ⅱ组)各256例及健康者(对照组)256名,用超声检查并测定下肢胫前、胫后动脉静息状态下(基础内径)、反应性充血后和舌下含服硝酸甘油后其动脉内径,并对其影响因素进行相关性分析。采用SPSS 16.0进行统计分析,单因素分析采用方差分析,多因素分析采用逐步回归法进行线性回归分析。结果单因素方差分析显示不同分组之间(糖尿病有无并发症及健康对照3组)在不同处理方式(基础内径、反应性充血及硝酸甘油诱发)后各动脉内径(胫前左侧右侧、胫后左侧右侧)值不同(P均<0.01)。不同处理组间各分组的不同动脉内径值不同(P均<0.01)。多因素线性回归显示不同分组不同处理方式后各动脉内径均受到多种因素影响,其中均受糖尿病病程的影响。结论采用B-Flow及多普勒超声技术检测下肢动脉血管内皮功能,能早期发现糖尿病血管病变,是评价糖尿病血管早期病变的有效方法,对早诊断、早治疗具有重要的临床应用价值。

Objective To test the endothelial function of lower extremity vessels in patients with type 2 diabetes by B-Flow and Doppler ultrasound and to explore its influencing factors.Methods The subjects were enrolled in 3 groups,type 2 diabetes patients without complications and type 2 diabetes patients with complications and normal healthy subjects（control group）,and every group had 256 cases.The endothelial function of lower extremity vessels of anterior and posterior tibial artery were tested using B-Flow and Doppler ultrasound in three statuses respectively,which included resting state（base diameter） and reactive hyperemia and sublingual nitroglycerin after its artery diameter.SPSS 16.0 were used for data entry and statistical analysis,variance analysis was used for single factor analysis and in linear regression analysis stepwise regression method was used for multivariate analysis.Results The ANOVA analysis showed statistically significant difference in inside diameter of anterior and posterior tibial artery（left and right respectively） with different treatments（base diameter,reactive hyperemia and nitroglycerin-induced） among three groups（diabetes without complications and diabetes with complications and normal control group）（P0.01）.And statistically significant difference was observed in inside diameter of anterior and posterior tibial artery（left and right respectively） among different treatment groups（P0.01）.The linear regression analysis showed many effective factors for every inside diameter of artery of different positions and treatments and groups,and the duration of diabetes was their common effective factor.Conclusion The B-Flow and Doppler ultrasound technique can be used for evaluating the early vascular lesions of diabetes and has important values in clinical application for early diagnosis and treatment.