糖尿病合并脑梗死患者颈动脉斑块及甲襞微循环观察

目的:观察2型糖尿病合并脑梗死(DMCI)患者颈动脉斑块及甲襞微循环变化。方法:将110例脑梗死患者分为DMCI组(n=40)和非糖尿病脑梗死组(NDMCI组,n=70),并设健康体检对照组(CON组,n=60)。采用彩色多普勒超声诊断仪测量各组双侧颈动脉内膜增厚及斑块形成;采用微循环检测系统观测各组甲襞微循环(NFM)形态、流态和袢周状态,并运用加权积分法分析比较各组分值和相关指标的变化。结果:DMCI组颈动脉内膜增厚者为15.00%,与NDMCI组的15.71%比较无明显差异,P>0.05;DMCI组颈动脉斑块占67.50%,显著高于ND-MCI组的54.29%,P<0.01。DMCI组NFM形态和袢周状态积分值与NDMCI组比较无显著差异,P>0.05;但DMCI组NFM流态积分值(2.16±0.70)明显高于NDMCI组(1.16±0.66),P<0.01;主要表现在DMCI组微血流呈粒缓流和/或粒摆流,甚至停滞,同时白色微小血栓(白微栓)数量及红细胞重度聚集和微血管渗出、出血均比NDMCI组严重,P<0.05。结论:2型糖尿病可明显增加脑梗死患者颈动脉斑块和微循环障碍。

Observation of Carotid Artery Plaques and Nail Fold Microcirculation in Diabetes Mellitus with Cerebral Infarction Patients

Objective:To investigate cerebral infarction in type 2 diabetes mellitus (DMCI) patients with carotid artery plaques and nail fold microcirculation(NFM).Method:110 cases of cerebral infarction patients were divided into DMCI group (n=40) and non-diabetic cerebral infarction group (NDMCI,n=70),and set healthy control group (CON,n=60).The carotid intimal-media thickening and plaque were measured by using color doppler ultrasonography; The NFM shape,flow pattern and the loop weekly status in each group were observed by microcirculation detecting system,and comparison difference among each group changes related indicators weighted integral.Results:DMCI group intima-media thickening was 15.00%,compared with NDMCI group (15.71%) there was no significant difference,P>0.05; DMCI group accounted carotid plaque for 67.50%,thich was significantly higher than NDMCI group 54.29%,P<0.01.DMCI group that vascular loop form and the loop around state of NFM compared with NDMCI no significant difference,P>0.05; but the DMCI group NFM micro-flow integral (2.16±0.70) was significantly higher than NDMCI group (1.16±0.66),P<0.01; DMCI group changes mainly in the micro-flow was slow flow or granular flow,or even stop the flow of,while tiny white thrombus (white micro-suppository) count,erythrocyte sevious aggregation,microvascular exudativing and bleeding,P<0.05.Conclusion:Type 2 diabetes can significantly increase the microcirculation dysfunction and carotid artery plaque for cerebral infarction patients.