超声造影评估2型糖尿病合并微血管病变骨骼肌微循环及动脉灌注储备的效果

Effect of contrast-enhanced ultrasound in assessing skeletal muscle microcirculation and arterial perfusion reserve in type 2 diabetes mellitus complicated with microangiopathy

目的探讨超声造影评估2型糖尿病(type 2 diabetes mellitus,T2DM)合并微血管病变(MC)骨骼肌微循环及动脉灌注储备的效果。方法选取2021年6月至12月在厦门市第五医院进行健康体检的健康人群20名作为对照组,同时选取20例同期在厦门市第五医院就诊的T2DM患者作为DM组,选取20例同期在厦门市第五医院治疗T2DM合并MC患者作为DM+MC组,三组均行超声造影检查,并配合短暂动脉闭塞检查,分析三组患者骨骼肌微循环及动脉灌注储备情况。结果DM+MC组部分造影剂渡越时间长于DM组及对照组,差异有统计学意义(P<0.05);短暂闭塞后,DM+MC组造影剂渡越时间长于DM组及对照组,差异有统计学意义(P<0.05);DM+MC组血糖、糖化血红蛋白、胰岛素、胰岛素抵抗指数、C-反应蛋白值、D-二聚体水平均高于DM组及对照组,差异有统计学意义(P<0.05);经相关性分析,糖化血红蛋白、胰岛素抵抗指数、C-反应蛋白值、D-二聚体水平和各组造影剂渡越时间及短暂动脉闭塞后各组造影剂渡越时间均存在正相关性(P<0.05)。结论超声造影在评估T2DM合并MC骨骼肌微循环障碍、动脉储备功能方面能够发挥积极作用,可推广。

Objective To investigate the effect of contrast-enhanced ultrasonography(CEUS)in assessing skeletal muscle microcirculation and arterial perfusion reserve in type 2 diabetes mellitus(T2DM)complicated with microvascular complations(MC).Methods Twenty healthy people who underwent physical examination in Xiamen Fifth Hospital from June to December 2021 were selected as the control group,and 20 patients with T2DM who were treated in Xiamen Fifth Hospital during the same period were selected as the DM group,and 20 T2DM combined with MC patients were treated in Xiamen Fifth Hospital during the same period were selected as the DM+MC group.Contrast-enhanced ultrasonography was performed in all three groups,combined with transient arterial occlusion examination.The skeletal muscle microcirculation and arterial perfusion reserve were analyzed in the three groups.Results The transit time of some contrast agents in the DM+MC group was significantly longer than that in the DM group and the control group,and the difference was statistically significant(P<0.05).The blood glucose,glycosylated hemoglobin,insulin,insulin resistance index,C-reactive protein value,D-dimer level of DM+MC group were higher than those of DM group and control group,the differences were statistically significant(P<0.05).After correlation analysis,there were positive correlations between glycosylated hemoglobin,insulin resistance index,C-reactive protein value,D-dimer level,the transit time of contrast agent in each group and the angiography of each group after transient arterial occlusion(P<0.05).Conclusion CEUS can play a positive role in evaluating skeletal muscle microcirculation disturbance and arterial reserve function in T2DM combined with MC,and it can be promoted.