超声方法测量心踝指数评价2型糖尿病患者动脉弹性的价值

目的探讨超声方法测量心踝指数（ cardio-ankle vascular index, CAVI）评价2型糖尿病患者动脉弹性的价值。方法选取30例健康成人和55例糖尿病患者，按照颈动脉内-中膜厚度（ intima-media thickness, IMT）将糖尿病患者分为A组（IMT〈1．0mm）和B组（IMT≥1．0mm），超声测量IMT及僵硬度系数口，分别采用全自动动脉硬化检测设备（振荡法）和超声法（M型和脉冲多普勒超声）测量CAVI（分别为CAVIp、CAVIm和CAVId）。结果A、B组的动脉弹性指标口、CAVIp、CAVIm、CAVId均较正常对照组显著增高（P〈0．05）；三组中，超声（M型和多普勒法）测量CAVI值均小于振荡法所测CAVI值，两两比较差异无统计学意义（P〉0．05）；经相关性分析，CAVIp与CAVIm、CAVId均相关性良好（r=0．996、0．974，P〈0．05），与CAVIm相关性更好；CAVIm与CAVId相关性良好（r=0．982，P〈0．01），两两间差异无统计学意义；三种方法测量的CAVI均与年龄、收缩压无显著相关，与IMT、口显著相关，以CAVIm相关性更好（r=0．423、0．336，P〈0．05）。结论糖尿病患者在血管粥样硬化形态学改变出现之前血管弹性功能已降低。超声可以无创简便地测量CAVI，且重复性好，与振荡法CAVI及其他弹性指标相关性良好。

Assessment of arterial elasticity in patients with type 2 diabetes mellitus by cardio-ankle vascular index measured by ultrasonography

Objective To evaluate the arterial elasticity in patients with type 2 diabetes mellitus （T2DM） by cardio-ankle vascular index （CAVI） measured by ultrasonography. Methods Fifty five T2DM patients, including 27 with carotid artery intima-media thickness （IMT） 〈 1.0 mm （group A） and 28 with IMT ≥ 1.0 mm （ group B ）, 30 healthy subjects （ group C） were enrolled in the study. The carotid artery IMT and fl stiffness index （fl） were measured by ultrasound; CAVI were measured by both ultrasound method （M-mode and Doppler ultrasonography ） and volume plethysmographic method. Results The artery elasticity indexes including fl, CAVIp, CAVIm and CAVId weresignificantly elevated in T2DM patients compared with healthy control （P 〈0.05 or P 〈0.01 ）. CAVI measured by three methods among all groups were similar and comparable （ All .P 〉 0.05 ）. CAVIp was significantly correlated with CAVIm and CAVId （ r = 0. 996 and 0. 974, respectively, all P 〈 0. 05）. CAVI values obtained by three methods were not correlated with age and systolic blood pressure （ SBP）, while significantly correlated with IMT and fl; particularly for CAVIm （ r = 0.423 and 0. 336, respectively, all P 〈 0.05 ）. Conclusion A decrease in arterial elasticity occurs prior to the morphological change in vascular atherosclerosis in T2DM patients. Ultrasound technique can measure CAVI noninvasively and reliably, and the results are comparable with that measured by plethysmographic method and other elastic index.