联合颈动脉和下肢动脉超声检查预测2型糖尿病患者发生心脑血管疾病的价值

The value of carotid artery and lower-extremity artery ultrasonography in predicting cardiovascular and cerebrovascular diseases in patients with type 2 diabetes mellitus

目的:探讨联合颈动脉和下肢动脉超声检查预测2型糖尿病(T2DM)患者发生心脑血管疾病(CCVD)的价值。方法:选择广州开发区医院2017年1月至2019年2月T2DM患者60例及30例健康志愿者为研究对象,分别进行生化检查和颈动脉、下肢动脉超声检查。比较T2DM患者与健康志愿者生化指标和颈动脉、下肢动脉内-中膜厚度(IMT)及颈动脉和下肢动脉粥样硬化分级,同时比较T2DM患者中CCVD患者与非CCVD患者颈动脉和下肢动脉粥样硬化分级情况。结果:与健康对照组相比,T2DM组空腹血糖水平显著升高(P<0.01),血脂四项同样也较高(P<0.05或0.01)。T2DM患者颈动脉和下肢动脉IMT值均高于健康对照者(P<0.01)。60例患者中31例患者颈动脉和下肢动脉粥样硬化分级一致,29例患者分级不一致。60例患者中12例CCVD,48例非CCVD,与非CCVD患者相比,CCVD患者中颈动脉和下肢动脉病变分级3~4级的患者比例更高(66.7%比19.7%,75.0%比16.7%),差异具有统计学意义(x^2=8.623,P=0.0033;x^2=13.34,P=0.0003)。结论:联合颈动脉和下肢动脉超声检查有助于预测2型糖尿病患者心脑血管疾病的发生。

Objective:To investigate the value of carotid artery and lower-extremity artery ultrasonography in predicting cardiovascular and cerebrovascular diseases(CCVD)in patients with type 2 diabetes mellitus(T2DM).Methods:Sixty patients with T2DM and 30 healthy volunteers in Guangzhou Development District Hospital from January 2017 to February 2019 were enrolled in the study.All patients underwent biochemical examination and ultrasound examination of carotid artery and lower-extremity artery.The biochemical indexes,intima-media thickness(IMT)values of carotid artery and lower-extremity artery and atherosclerotic grades of carotid artery and lower-extremity artery in T2DM patients and healthy volunteers were compared,and the atherosclerotic grades of carotid artery and lower-extremity artery in CCVD patients and non CCVD patients were compared.Results:Compared with healthy control group,the fasting blood glucose level,the four items of blood lipid and IMT values of carotid artery and lower-extremity artery in T2DM group was significantly higher(P<0.05 or 0.01).In 60 patients,31 patients had the same grade of carotid atherosclerosis and lower-extremity atherosclerosis,29 patients with different grades.Compared with the patients without CCVD,the patients with CCVD had a higher proportion(66.7%vs.19.7%,75.0%vs.16.7%)of carotid atherosclerosis and lower-extremity atherosclerosis grades 3-4,with significant differences(X^2=8.623,P=0.0033;X^2=13.34,P=0.0003).Conclusion:Combined carotid artery and lower-extremity artery ultrasonography is helpful to predict the occurrence of cardiovascular and cerebrovascular diseases in patients with type 2 diabetes mellitus.