无创动脉硬化检测及彩超技术联合应用对糖尿病患者早期动脉硬化的诊断价值

Application of noninvasive arteriosclerosis detection method and color ultrasound in diagnosing early arteriosclerosis of diabetics

目的探讨无创动脉硬化检测及彩超技术联合应用对2型糖尿病患者早期动脉硬化的诊断价值。方法选取120例2型糖尿病患者(糖尿病组)和同期100例健康体检者(对照组),分别利用血管彩色多普勒超声技术检测入选病例的颈总动脉内膜中层厚度(intimamedia thickness,IMT),以及动脉硬化检测仪测定其肱踝动脉的脉搏波传导速度(brachial-ankle pulse wave velocity,ba PWV)和趾臂指数(toe-brachial index,TBI),并分析相关检测数据和进行相关危险因素评价。结果两组测得的ba PWV、TBI和IMT比较,差异均有统计学意义(P<0.05)。多元线性回归分析结果表明:低/高密度脂蛋白胆固醇、尿酸和收缩压是IMT异常的危险因素;年龄、收缩压和血糖是baPWV异常的危险因素;年龄、收缩压和血糖是TBI异常的独立危险因素,高密度脂蛋白胆固醇是TBI的保护因素。结论结合无创动脉硬化检测指标并应用血管超声技术测量IMT,可以预测2型糖尿病患者早期外周动脉硬化程度,因其简便性、无创性和可重复性好而适宜临床推广应用。

Objective To explore the application of noninvasive arteriosclerosis detection meth-od and color ultrasound in diagnosing early arteriosclerosis among patients with type 2 diabetes. Methods One hundred and twenty patients with type 2 diabetes （ diabetes group） and homochro- nous 100 healthy controls（ control group） were enrolled in our study. Angeial color Doppler ultra-sound technique was utilized in detecting the intima-media thickness （IMT） of the common carotid arteries while arteriosclerosis detector was applied in measuring the brachial-ankle pulse wave veloci-ty （baPWV） and toe-brachial index （TBI）. Analysis and evaluation of risk factors was made based on the measured data. Results The differences of measured baPWV, TBI and IMT were all statisti-cally significant between the two groups（P 〈0. 05） . Multiple linear regression analysis showed that low（high）-density lipoprotein cholesterol, uric acid and systolic blood pressure were risk factors for abnormal IMT ; age, systolic blood pressure and blood sugar were risk factors for abnormal baPWV; age, systolic blood pressure and blood sugar were independent risk factors for abnormal TBI while high-density lipoprotein cholesterol was a protective factor for TBI. Conclusion The severity of early peripheral arteriosclerosis in patients with type 2 diabetes can be predicted with a combined ap-plication of noninvasive arteriosclerosis detection indexes and IMT measured by angeial ultrasound technique. It is fit for clinical promotion and application for its convenience, noninvasiveness and good repeatability.