M型超声评估2型糖尿病患者颈动脉粥样硬化程度

Evaluation of degree of carotid atherosclerosis in type 2 diabetic patients with M-mode ultrasound

目的探究M型超声评估2型糖尿病患者颈动脉粥样硬化程度的应用价值。方法选取2018年6月至2020年6月我院200例2型糖尿病患者作为研究对象,根据颈动脉内中膜厚度(IMT)及有无粥样斑块形成分为A组(IMT≥1.0 mm,有粥样斑块形成)、B组(IMT<1.0 mm,无粥样斑块形成),各100例,另选取100例血糖正常、IMT<1.0 mm、无粥样斑块形成的人群作为对照组。统计3组M型超声参数[颈总动脉、颈内动脉管壁峰值搏动幅度(PW)、达峰时间(PT)、管壁搏幅收缩期加速度(AC)],Spearman分析M型超声参数与IMT、粥样斑块形成关系,绘制受试者工作曲线(ROC)分析各指标单一预测糖尿病颈动脉粥样硬化程度价值,Logistic回归模型分析糖尿病患者颈动脉粥样硬化程度的影响因素。结果 A组颈总动脉、颈内动脉PW、PT、AC低于B组、对照组,B组低于对照组,且均与IMT、粥样斑块形成呈负相关(P<0.05);颈总动脉PT预测糖尿病患者发生颈动脉粥样硬化价值的曲线下面积(AUC)(0.790)>颈总动脉PW(0.754)>颈总动脉AC(0.703)。结论 M型超声PW、PT、AC参数与糖尿病患者颈动脉粥样硬化程度存在一定相关性,在糖尿病患者颈动脉粥样硬化发生中具有良好预测价值,可为临床诊治及预防提供可靠参考依据。

Objective To explore the value of M-mode ultrasound in evaluating the degree of carotid atherosclerosis in type 2 diabetic patients. Methods From June 2018 to June 2020,200 diabetic patients in our hospital were selected as the research object. According to the carotid intima-media thickness(IMT) and the presence or absence of atherosclerotic plaque formation,they were divided into group A(IMT ≥10 mm, with atheromatous plaque formation), group B(IMT<10 mm,without atheromatous plaque formation), 100 cases in each. 100 patients with normal blood glucose, IMT<10 mm,and no plaque formation were selected as the control group. The M-mode ultrasound parameters [common carotid artery,internal carotid artery wall peak pulsation amplitude(PW), peak time(PT), tube wall amplitude systolic acceleration(AC)] of the three groups were counted. Spearman analysis and multivariate linear step-wise regression analysis of the relationship between M-mode ultrasound parameters and IMT and atheromatous plaque formation.A receiver operating curve(ROC) was drawn to analyze the single index and joint prediction of the value of carotid atherosclerosis in diabetes. Results PW, PT, AC of common carotid artery and internal carotid artery in group A were lower than those in group B and control group,group B was lower than control group,and they were all negatively correlated with IMT and atheromatous plaque formation(P<0.05). Area under the curve(AUC) of common carotid artery PT to predict carotid atherosclerosis in diabetic patients(0.790)>PW(0.754)>AC(0.703). Conclusion The PW, PT, AC parameters of M-mode ultrasound have a certain correlation with the degree of carotid atherosclerosis in diabetic patients,and have good predictive value in the occurrence of carotid atherosclerosis in diabetic patients,and can provide a reliable reference for clinical diagnosis, treatment and prevention.