高频超声联合声辐射脉冲成像技术在糖尿病肌少症中的应用价值

Application value of high frequency ultrasound combined with acoustic radiation force impulse in diabetic sarcopenia

目的 探讨高频超声联合声辐射脉冲成像技术在糖尿病肌少症(DSA)中的应用价值.方法 选取 2022 年 1 月至 2023 年 2 月于福建医科大学附属龙岩第一医院内分泌科住院治疗的T2DM患者 196 例,根据四肢骨骼肌质量指数(ASMI)分为单纯T2DM组(n=120)及合并DSA组(DSA,n=76),同期选取40 名体检健康者为正常对照(NC)组.分析各组一般资料及生化指标,比较右侧腓肠肌内侧头肌肉厚度、羽状角、肌束长度及剪切波速度.结果 DSA组右侧腓肠肌内侧头肌肉厚度、羽状角、肌束长度及剪切波速度低于NC、T2DM组(P<0.05).Pearson相关分析显示,ASMI与体重、BMI、TC、白蛋白、总蛋白、肌肉厚度、羽状角、肌束长度及剪切波速度呈正相关(P<0.05),与年龄、FPG、HbA1c呈负相关(P<0.05).二元Logistic回归分析显示,肌肉厚度、剪切波速度是DSA的影响因素.受试者工作特征(ROC)曲线分析显示,肌肉厚度、剪切波速度ROC曲线下面积为0.826、0.877(P<0.05),诊断DSA的阈值为 14.1 mm、1.63 m/s,敏感度为 0.953、0.903,特异度为 0.971、0.941.结论 超声测量右侧腓肠肌内侧头肌肉厚度及剪切波速度,可用于诊断DSA.

Objective To explore the clinical application value of high frequency ultrasound combined with acoustic radiation force impulse in patients with diabetic sarcopenia(DSA).Methods A total of 196 patients with type 2 diabetes mellitus(T2DM)who were hospitalized in the Endocrinology Department of the First Affiliated Hospital of Longyan City,Fujian Medical University were enrolled in this study from January 2022 to February 2023.All the participants were divided into two groups:simple T2DM group(n=120)and combined DSA group(DSA,n=76)according to the limb skeletal muscle mass index(ASMI).During the same period,40 healthy individuals who underwent physical examination were selected as the normal control(NC)group.The general information and biochemical indicators were analyzed in each group.And the muscle thickness,pinnate angle,muscle bundle length and shear wave velocity of the medial head of the right gastrocnemius muscle were compared among the groups.Results The thickness,feathery angle,muscle bundle length,and shear wave velocity of the medial head muscle of the right gastrocnemius muscle were lower in DSA group than in NC and T2DM groups(P<0.05).Pearson correlation analysis showed that ASMI was positively correlated with body weight,BMI,TC,albumin,total protein,muscle thickness,feather angle,muscle bundle length,and shear wave velocity(P<0.05),while negatively correlated with age,FPG and HbA1c(P<0.05).Binary logistic regression analysis showed that muscle thickness and shear wave velocity are influencing factors for DSA.The analysis of the receiver operating characteristic(ROC)curve of the subjects showed that the area under the ROC curve of muscle thickness and shear wave velocity was 0. 826 and 0. 877( P<0. 05). The diagnostic thresholds for DSA were 14. 1 mm and 1. 63 m/s,with sensitivity of 0. 953 and 0. 903,and specificity of 0. 971 and 0. 941. Conclusions Ultrasound measurementof the muscle thickness and shear wave velocity of the medial head of the right gastrocnemius muscle can beused to diagnose diabetic sarcopenia.