实时超声弹性成像技术评价2型糖尿病患者跟腱弹性

Evaluation of Achiles tendon in type 2 diabetes mellitus patients with real-time ultrasound elastography

目的探讨应用实时超声弹性成像（RTE）技术评价2型糖尿病（T2DM）患者跟腱的弹性异常改变及临床意义。方法 62例T2MD患者按病程〈5年、5~10年、〉10年分为A（n=21）、B（n=20）、C组（n=21）。同期选取23名健康志愿者为对照组。对各组均行跟腱RTE检查。将跟腱分为上、中、下段,应用弹性分级法分为1、2、3级;并以跟腱为A区,跟腱深部脂肪组织为B区,测算跟腱与其深部脂肪组织的弹性比值（B/A值）。结果上、中、下段跟腱弹性分级为1级者B、C组均较对照组增加,2、3级者减少（P均〈0.05）。上段跟腱弹性分级为1级者C组较A组增加,2、3级者减少（P均〈0.05）。中段跟腱弹性分级为1级者C组较A、B组增加,2、3级者减少（P均〈0.05）。下段跟腱弹性分级为1级者C组较A组增加,2、3级者减少（P均〈0.05）。A、B、C组下段跟腱B/A值（2.73±0.58、3.50±1.44、4.37±1.27）均高于对照组（2.23±0.33）,且T2MD各病程组间差异均有统计学意义（P均〈0.05）。结论应用RTE技术可较为客观、准确地评价T2DM患者跟腱弹性异常改变。

Objective To evaluate the elasticity changes of Achilles tendon and clinical significance in type 2 diabetes mel- litus （T2DM） patients with real-time ultrasound elastography （RTE）. Methods According to the course 〈5 years, 5-10 years and 〉10 years, 62 patients with T2DM were divided into group A （n= 21）, B （n= 20） and C （n= 21）. Twenty-three healthy volunteers were enrolled as control group. The segments of the Achilles tendons in each group were examined with RTE. Achilles tendon were divided into three segments, including the upper segment, middle segment and lower segment. And the elasticity grading classificated 1, 2 and 3. The ratio of B/A was obtained by taking Achilles tendon as A zone, the deep fat tissue of Achilles tendon as B zone. Results The Achilles tendons with elasticity grade 1 of the up- per, mid and lower segments of in group B and C were more than control group, and the tendons with elasticity grade 2 or 3 were less than control group （all P〈0.05）. For upper segment, the tendons with elasticity grade 1 in group C were more than group A, and the tendons with elasticity grade 2 or 3 were less than group A （all P〈0.05）. For mid segment, the tendons with elasticity grade 1 in group C were more than group A and B, and the tendons with elasticity grade 2 or 3 were less than group A and B （all P〈0.05）. For lower segment, the tendons with elasticity grade 1 in group C were more than group A, and the tendons with elasticity grade 2 or 3 were less than group A （all P〈0.05）. The ratio of B/A in the lower segment of Achilles tendons of group A （2.73±0.58）, B （3.50±1.44） and C （4.37±1.27） were higher than that of con- trol group （2.23±0. 33）. Conclusion The elasticity of the Achilles tendon in patients of T2DM can be evaluated by RTE objectively.