超声极速成像脉搏波技术评估青中年2型糖尿病病人颈动脉弹性的价值

The value of ultrafast ultrasonic imaging pulse wave velocity technique in the evaluation of carotid artery elasticity in young and middle-aged patients with type 2 diabetes mellitus

目的探讨超声极速成像脉搏波(ufPWV)技术在定量检测青中年2型糖尿病(T2DM)病人颈动脉弹性的应用价值。方法选择2019年9月至2020年7月合肥市第二人民医院收治的77例18~60岁的青中年T2DM病人作为病例组,选择同期18~60岁的来该院健康体检者77例作为对照组。收集两组病人的一般临床资料、实验室数据、常规超声测量参数及颈动脉弹性指标[收缩期开始时脉搏波传导速度(BS-PWV)和收缩期结束时脉搏波传导速度(ES-PWV)]。按年龄分为青年亚组和中年亚组,分别比较两组间各项指标有无差异,并进一步将病例组的糖化血红蛋白(HbA1c)和内中膜厚度(IMT)分亚组进行分析。结果青年亚组和中年亚组T2DM病人左、右侧IMT[(青年:(0.58±0.09)mm、(0.56±0.11)mm;中年:(0.60±0.09)mm、(0.59±0.10)mm)],左、右侧BS-PWV[青年:(5.36±0.82)m/s、(4.61±1.03)m/s;中年:(5.83±1.42)m/s、(4.92±1.22)m/s],左、右侧ES-PWV[青年:(6.55±1.50)m/s、(5.64±1.34)m/s,中年:(8.09±2.02)m/s、(7.32±1.98)m/s]和双侧IMT[青年:(0.57±0.09)mm,中年:(0.60±0.08)mm]、双侧BS-PWV[青年:(4.98±0.64)m/s、中年:(5.37±0.98)m/s]、双侧ES-PWV[青年:(6.09±1.09)m/s、中年:(7.70±1.70)m/s]均高于对照组(P<0.05)。两个年龄组T2DM病人各自组内HbA1c增高组与HbA1c正常组比较,均除左侧BS-PWV外其余指标差异有统计学意义(P<0.05)。两个年龄组T2DM病人的BS-PWV和ES-PWV在各自组内不同IMT组间差异有统计学意义(P<0.05),且随着IMT的增高,BS-PWV和ES-PWV均有上升的趋势(趋势检验P<0.05)。结论ufPWV技术可无创检测青中年T2DM病人颈动脉弹性功能,为临床早期治疗提供指导价值。

Objective To discuss the application value of ultrafast ultrasonic imaging pulse wave velocity(ufPWV)technique in the quantitative measure of carotid artery elasticity in young and middle-aged patients with type 2 diabetes mellitus(T2DM).Methods Totally 77 young and middle-aged patients with T2DM,admitted to the Second People's Hospital of Hefei from September 2019 to July 2020,were selected as the case group,and 77 healthy people who came to the hospital for physical examination during the same period were selected as the control group.Their ages ranged from 18 to 60.General clinical and laboratory data,common ultrasonic measurement parameters and carotid artery elasticity indexes,i.e.pulse wave velocity at the beginning of systole(BS-PWV)and pulse wave velocity at the end of systole(ES-PWV)were collected.According to age,they were divided into young subgroup and middle-aged subgroup.The difference in each index between the two groups was compared.Furthermore,the HbA1c and intima-media thickness(IMT)of the case group were subdivided into subgroups for analysis.Results Left and right IMT[youth subgroup:(0.58±0.09)mm,(0.56±0.11)mm;middle-aged subgroup:(0.60±0.09)mm,(0.59±0.10)mm],left and right BS-PWV[youth subgroup:(5.36±0.82)m/s,(4.61±1.03)m/s;middle-aged subgroup:(5.83±1.42)m/s,(4.92±1.22)m/s],left and right ES-PWV[youth subgroup:(6.55±1.50)m/s,(5.64±1.34)m/s;middle-aged subgroup:(8.09±2.02)m/s,(7.32±1.98)m/s]and bilateral IMT[youth subgroup:(0.57±0.09)mm,middle-aged subgroup:(0.60±0.08)mm],bilateral BS-PWV[youth subgroup:(4.98±0.64)m/s,middle-aged subgroup:(5.37±0.98)m/s],bilateral ESPWV[youth subgroup:(6.09±1.09)m/s,middle-aged subgroup:(7.70±1.70)m/s]in the young and middle aged T2DM patients groups were higher than those of the control group.In each of the group,in comparison with normal HbA1c subgroup,there were significant differences in all the indexes except for left BS-PWV in increased HbA1c subgroup(P<0.05).In both young and middle-aged groups,there were statistically significant differences in BS-PWV and ES-PWV of T2DM patietns among different IMT subgroups within each group(P<0.05).Moreover,with the increase in IMT,both BS-PWV and ES-PWV tend to increase(trend test P<0.05).Conclusion UfPWV technique can noninvasively measure elastic function of carotid artery in young and middle-aged T2DM patients,which provides guidance value for early treatment.