踝肱指数高值糖尿病患者下肢动脉粥样硬化病变的超声特点

Ultrasonographic characteristics of lower limb atherosclerosis in diabetic patients with a high ankle-brachial index

目的分析踝肱指数(ABI)高值糖尿病患者下肢动脉粥样硬化病变的超声特点。方法随机选取糖尿病患者92例,根据ABI值分为:ABI高值组(23例,ABI>1.3)、AB1正常组(39例,ABI 0.9～1.3)及ABI低值组(30例,ABI<0.9),根据下肢动脉超声结果,对下肢动脉粥样硬化病变进行分析。结果与ABI低值组比较,ABI高值组患者下肢动脉病变闭塞率明显降低(63.3%vs 4.3%,P<0.05);ABI高值组患者下肢动脉粥样硬化病变主要表现为弥漫性斑点状强回声及小斑块病变(82.6%),并且,病变主要分布于下肢远端(44.4%)。ABI正常组患者下肢动脉粥样硬化病变以近端为主(81.8%)。结论 ABI高值患者下肢动脉粥样硬化病变的临床特征与动脉内膜中层钙化的病变特征一致,表明ABI高值对糖尿病患者动脉内膜中层钙化具有较高的预测价值。

Objective To analyze the ultrasonoraphic characteristics of lower limb atherosclerosis in diabetic patients with a high ankle-braehial index（ABI）. Methods Ninety-two diabetic patients were randomly divided into high ABI group（n=23 with their ABII. 3） ,normal ABI group（n= 39 with their ABI=0. 9-1. 3） ,and low ABI group（n=30 with their ABI〈0.9）according to their ABI. Their lower limb atherosclerosis was analyzed by variance analysis. Results The incidence of lower limb arthrosclerosis obtiterans was significantly lower in high ABI group than in low ABI group（4.30//oo vs 63.3% ,P〈0. 05）. The lower limb atherosclerosis in high ABI group was mainly manifested as diffuse dot-like hyperechogenicity spots or as small plaques（82.6%）and mainly distributed in the distal limb（44.4%）. Conclusion The clinical manifestations of lower limb atherosclerosis are similar to those of artery media calcification in patients with a high ABI, indicating that high ABI is of a rather high predictive value for the artery media calcification in diabetic patients.