超声对糖尿病患者颈动脉内膜中膜厚度测定与血管内皮损伤的分析

Correlation between carotid artery ultrasonography and carotid intima-media thickness determination and vascular endothelial injury in diabetic patients

目的通过血管超声测定颈动脉内膜中膜厚度(CIMT),并探讨CIMT与血管内皮损伤的相关性,以期为糖尿病心脑血管并发症的防治提供依据。方法选取2型糖尿病患者71例设为观察组,选取同期于我院进行健康体检者69例,设为对照组,受试者进行血管超声检查,在颈动脉壁取3个测定点测定CIMT厚度,取平均值。肱动脉测量方法采用Celermajer法,测量静息状态、充气加压、含服硝酸甘油前后肱动脉内径,计算肱动脉内径变化率。结果测量基础值组间差异无统计学意义(P>0.05),具有可比性。观察组CIMT数值显著高于对照组,差异有统计学意义(P<0.01)。充气加压状态下及含服硝酸甘油后观察组肱动脉内径变化率显著低于对照组,差异有统计学意义(P<0.01)。CIMT厚度与肱动脉内径变化率(含药前后)呈负相关(r=-0.41,P<0.05);CIMT厚度与肱动脉内径变化率(充气加压)呈负相关(r=-0.60,P<0.05)。结论2型糖尿病患者代谢紊乱所致血管内皮功能障碍时造成血管壁重构,出现CIMT厚度增加以及粥样斑块形成,动脉粥样硬化的发生会受到血管内皮损伤的影响。

Objective To determine the thickness of carotid intima-media thickness(CIMT)by vascular ultrasonography and to investigate the correlation between CIMT and vascular endothelial injury in order to provide basis for the prevention and treatment of cardiovascular and cerebrovascular complications in diabetes.Methods Seventy-one patients with type 2 diabetes were enrolled as observation group.Sixty-nine patients who had physical examination in our hospital during the same period were selected as the control group.The subjects underwent vascular ultrasonography,and three CIMTs were measured at the carotid artery wall.Thickness,averaged.Radial artery measurement method Celermajer method was used to measure resting state,inflation pressure,and iliac artery diameter before and after the administration of nitroglycerin to calculate the radial artery diameter change rate.Results There was no statistically significant difference between the baseline values(P>0.05).The results were comparable.The CIMT value of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.01).The rate of change of the radial diameter of the radial artery was significantly lower in the pressurized group and in the observation group than in the control group(P<0.01).The CIMT thickness was negatively correlated with the radial artery diameter change rate(before and after drug inclusion)(r=-0.41,P<0.05);the CIMT thickness was negatively correlated with the radial artery diameter change rate(inflated pressure)(r=-0.60,P<0.05).Conclusion Vascular wall remodeling is caused by vascular endothelial dysfunction caused by metabolic disorders in patients with type 2 diabetes.The thickness of CIMT increases and the formation of atheromatous plaques.The occurrence of atherosclerosis is affected by the damage of the vascular endothelium.