2型糖尿病患者颅内、颈部、下肢动脉粥样硬化性病变的超声研究

目的评估2型糖尿病患者同一个体颅内动脉、颈动脉、下肢动脉病变的超声检测特征。方法收集2008年9月至2009年8月确诊为2型糖尿病的住院患者354例,应用经颅多普勒(TCD)、CDFI对颅内动脉、颈动脉、下肢动脉进行检测,分析糖尿病患者动脉内-中膜厚度、斑块的形成、管腔狭窄及闭塞的发生率、发病特征,观察单一个体不同部位发病的差异。结果糖尿病患者同一个体不同部位动脉硬化病变特点:(1)颈动脉内中膜增厚发生率、斑块发生率均高于下肢动脉,两者差异有统计学意义。但斑块形成特点一致,均以多发斑块居多,以钙化性强回声斑块为主,形态以规则型为主。(2)动脉狭窄以颅内动脉最高发,颅内动脉与颈部动脉、下肢动脉病变的发生率比较均有显著性差异,而颈部动脉与下肢动脉狭窄率比较,差异无统计学意义。(3)颅内动脉狭窄特点以多支动脉的轻度狭窄为主,前循环狭窄发生率高于后循环,并以大脑中动脉最为高发。(4)下肢动脉斑块的发生率以股总动脉最常见,而管腔狭窄、闭塞则以膝以下末梢动脉受累最为明显。结论联合应用CDFI与TCD能对2型糖尿病血管病变进行形态学评价,对预测和预防糖尿病患者脑血管、下肢血管并发症的发生有临床实际意义。

Evaluation of the atherosclerostic characteristics in intracranial arteries, carotid arteries, and lower extremity arteries by ultrasonography in patients with type 2 diabetes

Objective To evaluate the characteristics of atherosclerosis and its occurrence profiles for intracranial arteries, carotid arteries, and lower extremity arteries in patients with type 2 diabetes mellitus by Color Doppler flow imaging(CDFI) and Transcranial Doppler (TCD ). Methods A total of 354 patients diagnosed as type 2 diabetes from September 2008 to April 2010 were recruited into this study. Hemodynamic characteristics in intracranial arteries were examined by TCD. The morphological features and hemod...