彩色多普勒技术测定动脉踝肱指数在2型糖尿病外周血管病变中的应用

目的:采用彩色多普勒血流成像技术测定2型糖尿病患者的踝肱指数,研究踝肱指数与糖尿病合并血管病变的关系,为临床T2DM患者血管病变的早期诊断提供依据。方法:选择健康志愿者40例(A组)及包头医学院第一附属医院住院的65例2型糖尿病患者,均按WHO诊断标准及临床特点确诊,采用飞利浦IU22彩色超声诊断仪测定踝肱指数,以踝肱指数 < 0.9为外周血管病变组(B组),踝肱指数 ≥ 0.9为非外周血管病变组(C组),应用单因素方差分析比较两组病人的年龄、性别、病程、血脂及糖化血红蛋白等各项检验指标及踝肱指数,以P < 0.05认为差异有统计学意义。结果:65例2型糖尿病患者中B组21例,其中出现足部的坏疽及溃疡的1例,出现足背动脉搏动减弱、间歇性跛行或静息痛6例,下肢动脉的硬化狭窄17例;C组44例,其中足背动脉搏动减弱、间歇性跛行或静息痛有3例,无一例发生足部的坏疽及溃疡,无下肢动脉的硬化狭窄,两组间差异有统计学意义(P < 0.05)。结论:2型糖尿病患者中踝肱指数降低程度与外周血管病变发生率呈正相关,两组 组临床资料比较,前者具有年龄大、病程长、血脂、糖化血红蛋白明显升高的特点。彩色多普勒血流成像技术检测2型糖尿病患者踝肱指数,可用于判断2型糖尿病患者外周血管病变程度,为临床预防其的发生发展提供可靠依据。

Metastasia Lesion of Gestation Trophoblastic Tumor in Abdominopelvic Cavity Diagnosed by Sonographic and Doppler Imaging

Objective: The purpose of this study was to review clinical data of metastasia lesion of gestation trophoblastic tumor (GTT) in abdominopelvic cavity by color Doppler ultrasound. Subjects and Methods: A retrospective analysis of 13 cases of GTT in China was performed. Clinical appearances, serum human chorionic gonadotropin (hCG) levels, sonographic findings, Doppler waveforms, and patient outcomes were followed up. Color Doppler ultrasound was performed to diagnose the presence of GTT, detect metastasia lesion in abdominopelvic cavity, assess disease recurrence, and monitor the efficacy of chemotherapy. Results: Of the 13 patients with GTT, 4 had choriocarcinoma which 3 cases occurred after an abortion, 1 after a year of dilation and suction evacuation for the hydatidform mole. Metastasia lesion in abdominopelvic cavity was detected by color Doppler ultrasound in all cases of choriocarcinoma, among which the metastasia lesion were found at uterine fundus, near uterus, colon and cystic vascular space near the uterus, repectively. 9 cases with an invasive hydatidiforn mole (IHM) occurred after one to three months of dilation and suction evacuation for the hydatidform mole, consistant with the hCG levels markedly elevating. Metastasia lesion in abdominopelvic cavity was also detected by color Doppler ultrasound besides invasive lesion in uterine muscular layer in all cases of IHM, among which 3 cases showed metastasia lesion in cystic vascular space near the uterus, 2 cases were detected in side wall of pelvic cavity, while the rest were found in abdominal cavity, right kidney, colon and near uterus, respectively. Meanwhile, the image of metastasia lesion with IHM was similar to choriocarcinoma’s. And the reticular structure, the cystic vascular space and solid lesion may be showed by ultrasound. The metastasia lesion had abundant flow. Doppler waveforms showed resistive indices of 0.34 (SD 0.07) for metastasia lesion. There was the same lower-impedance as invasive lesion in uterine muscular layer. Except an IHM with the renal metastasia lesion having been followed, abnormal sonographic and Doppler findings in other metastasia disease all disappeared after surgical operation or chemotherapy were successful. Conclusions: Sonography and Doppler imaging were helpful in detecting metastasia lesion in abdominopelvic cavity, and in following the effectiveness of chemotherapy. And it should be taken full examination for GTT by Color Doppler ultrasound in order to avoid mistake.

Reference values of carotid intima-media thickness and arterial stiffness in Chinese adults based on ultrasound radio frequency signal:A nationwide,multicenter study

Background:Carotid intima-media thickness(IMT)and diameter,stiffness,and wave reflections,are independent and important clinical biomarkers and risk predictors for cardiovascular diseases.The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods:A total of 3053 healthy Han Chinese adults(1922 women)aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022.The real-time tracking of common carotid artery walls was achieved by the radio frequency(RF)ultrasound system.The IMT,diameter,compliance coefficient,βstiffness,local pulse wave velocity(PWV),local systolic blood pressure,augmented pressure(AP),and augmentation index(AIx)were then automatically measured and reported.Data were stratified by age groups and sex.The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions.The major clinical determinants of carotid properties were identified by Pearson’s correlation,multiple linear regression,and analyses of covariance.Results:All the parameters of carotid properties demonstrated significantly age-related trajectories.Women showed thinner IMT,smaller carotid diameter,larger AP,and AIx than men.Theβstiffness and PWV were significantly higher in men than women before forties,but the differences reversed after that.The increase rate of carotid IMT(5.5µm/year in women and 5.8µm/year in men)and diameter(0.03 mm/year in both men and women)were similar between men and women.For the stiffness and wave reflections,women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes(all P for age by sex interaction<0.05).The blood pressures,body mass index(BMI),and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex.Conclusions:The age-and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established.The blood pressures,BMI,and triglyceride levels should be considered for clinical application of corresponding reference values.