摘要
目的通过超声造影(contrast-enhanced ultrasound,CEUS)评估小腿三头肌的微循环灌注情况,探讨CEUS在2型糖尿病(type 2 diabetes mellitus,T2DM)微血管病变评估中的应用价值。方法收集2020年8月至2023年1月在温州医科大学附属第二医院内分泌科住院治疗的T2DM患者51例,分为单纯T2DM组(n=15)、T2DM微循环病变组(n=36),记录每位患者的糖化血红蛋白(hemoglobin A1c,HbA1c)和胰岛素抵抗指数(homeostatic model assessment for insulin resistance,HOMA-IR)。CEUS观察小腿三头肌的造影情况,获取定量造影指标区域增强强度(enhanced intensity,PI-BI)和区域达峰时间(regional peak time,TTP-AT),并进行组间对比分析。结果T2DM微变组的HbA1c及HOMA-IR高于单纯T2DM组(P<0.05)。T2DM微变组腓肠肌内侧头(musculi gastrocnemii,MG)、腓肠肌外侧头(laterale musculi gastrocnemi,LG)、比目鱼肌(soleus,SOL)及交界区的TTP-AT均长于单纯T2DM组(P<0.05)。两组SOL的TTP-AT均为最长,LG次之,MG最短(P<0.05)。T2DM微变组MG的PI-BI高于SOL(P<0.05)。小腿三头肌交界区的TTP-AT与HbA1c、HOMA-IR之间均呈正相关(P<0.05)。结论CEUS小腿三头肌TTP-AT是评估T2DM患者微血管病变的新指标。
Objective To explore the value of contrast-enhanced ultrasound(CEUS)in the assessment of diabetic microangiopademia through evaluating microcirculation perfusion of triceps surae muscle by CEUS.Method Totally 51 patients with type 2 diabetes mellitus(T2DM)admitted in our hospital between August 2020 and January 2023 were collected,including 15 pure T2DM patients and 36 T2DM patients complicated with microcirculatory disturbance(T2DM+CM).Each patient’s hemoglobin A1c(HbA1c)and homeostatic model assessment for insulin resistance(HOMA-IR)were recorded.After getting enhanced intensity(PI-BI)and regional peak time(TTP-AT)by CEUS,comparative analysis between groups was conducted.Results The levels of HbA1c and HOMA-IR in T2DM+CM group were higher than those in pure T2DM group(P<0.05).TTP-AT in T2DM+CM group were longer than that in pure T2DM group of all muscles musculi gastrocnemii(MG),laterale musculi gastrocnemi(LG),soleus(SOL)and triceps surae muscle’s junction region)(P<0.05).The TTP-AT of SOL was longest in both groups,followed by LG,and MG(P<0.05).The PI-BI had no significant difference among MG,LG and SOL in pure T2DM group.The PI-BI of MG was higher than that of SOL in the T2DM+CM group(P<0.05).TTP-AT of triceps surae muscle’s junction region had significant positive association with both HbA1c and HOMA-IR(P<0.05).Conclusion The TTP-AT of triceps surae muscle measured by CEUS is a new indicator for evaluating microangiopathopathy in T2DM patients.
作者
王鹏飞
叶蔓菁
徐茂晟
邹春鹏
董雁雁
WANG Pengfei;YE Manjing;XU Maosheng;ZOU Chunpeng;DONG Yanyan(Department of Ultrasound,the 2nd Affiliated Hospital and Yuying Children’s Hospital of WMU,Wenzhou 325000,Zhejiang,China)
出处
《中国现代医生》
2024年第5期35-39,共5页
China Modern Doctor
基金
浙江省温州市科技局科研项目(Y2020795)。
关键词
超声造影
2型糖尿病
骨骼肌
微循环
Contrast-enhanced ultrasound
Type 2 diabetes mellitus
Skeletal muscle
Microcirculation