彩色多普勒超声对2型糖尿病患者下肢动脉病变的诊断价值及相关因素分析

Ultrasound diagnosis and related factors analysis of lower limb arterial lesions in patients with type 2 diabetes

目的探讨彩色多普勒超声（CDFI）对2型糖尿病患者下肢动脉病变的诊断价值及发病相关因素。方法选取2型糖尿病患者70例作为观察组，以同期住院的非2型糖尿病患者60例作为对照组，两组均行下肢动脉CDFI检查并进行比较。结果观察组下肢动脉血管壁内膜中层厚度（IMT）异常、粥样硬化斑块及管腔狭窄闭塞的检出率分别为82．86％、60．0％、22．86％，显著高于对照组的28．33％、16．67％、5．0％（x^2=4．38、12．84、7．53，均P〈0．05）；观察组患者下肢动脉斑块发生部位以股动脉、胫后动脉和胫前、足背动脉多见，发生率分别为42．86％、10．0％、42．86％、48．57％，对照组为11．67％、6．67％、3．33％、3．33％，两组差异有统计学意义（x^2=4．87、12．75、13．97，均P〈0．05）。2型糖尿病患者下肢动脉病变发病的相关因素包括年龄、血压、糖化血红蛋白、血脂（TC、TG、HDL—C），与对照组差异有统计学意义（t=13．26、5．34、4．00、89．00、6．54、7．54，均P〈0．05）。结论CDFI检查是2型糖尿病患者下肢动脉病变诊断的可靠手段，可确定病变的部位、长度、阻塞的程度以及血管解剖结构的异常，具有重要的临床价值。

Objective To investigate the color Doppler flow imaging （CDFI） diagnosis value and related factors analysis of lower limb arterial lesions in patients with type 2 diabetes. Methods 70 cases with type 2 diabetes as observation group, 60 not-type 2 diabetes patients as control group in the same period were selected,who were given lower limb artery CDFI examination and comparison. Results Lower limb artery blood wall intima-media thickness （IMT） abnormal, atherosclerotic plaques, luminal stenosis, occlusion detection rate of the observation group were 82. 86% ,60.0% ,22.86% ,they were significantly higher than 28.33%, 16.67% ,5.0% of the control group（ x^2 = 4.38,12.84,7.53, all P 〈 0. 05 ） ; the lower limb artery plaque location of the observation group often was seen in the femoral artery, posterior tibialis artery and the anterior tibialis, dorsalis pedis artery in 42.86%, 10.0% ,42.86%, 48.57% ,compared with 11.67%,6.67%,3.33%,3.33% of the control group, there were significant differences （ x^2 = 4.87,12.75,13.97, all P 〈 0.05 ）. In the observation group, the related factors of type 2 diabetes lower limb arterial pathological including age, blood pressure, glycosylated hemoglobin, blood lipid （ TC, TG, HDL-C）, there were significant differences compared with the control group （t = 13.26,5.34,4.00,89.00,6.54,7.54, all P 〈 0.05 ）. Conclusion The CDFI examination is a reliable diagnosis means of patients with type 2 diabetes lower limb artery lesions,which can determine the lesion site,length,jam extent and vascular anatomical abnormalities, and has an im- portant clinical value.