彩色多普勒超声检查对早期2型糖尿病患者大血管病变的诊断价值

目的　评价彩色多普勒超声检查法 (彩超 )在确诊 1年内的 2型糖尿病 (T2DM)患者体表及体内大血管病变检测中的应用价值。　方法　使用宽频探头在规定的范围内 ,对颈总动脉、颈动脉窦、髂总动脉、股动脉及肱动脉于舒张期测量其前、后壁内膜至中层的厚度 ,并对病变血管的分布、好发部位和发病情况进行统计学分析。　结果　检测 2 36例患者 ,有大血管病变的 85例 ,患病率为36 % ;共有病变 14 3处 ,其中股动脉与髂总动脉患病率累计及分别与颈总动脉、颈动脉窦及肱动脉相比差异有非常显著意义 (P <0 0 1) ;两支血管以上病变明显高于单支血管病变 (P <0 0 1) ;血管病变部位以后壁及血管分支处为多 (含颈动脉窦 ) ,明显高于前壁病变 (P <0 0 1)。　结论　确诊病程只有 1年的T2DM患者已存在多处体表大血管病变 ;彩超能在体表无创、直观地检测出大血管有无动脉粥样硬化。

The research of detecting macrovascular lesions in type 2 diabetes mellitus by color doppler ultrasonography

Objective To evaluate the significance of color doppler ultrasonography (CDU) on the diagnosis of the prevalence, location of superficial macrovascular lesions in type 2 diabetes mellitus. Methods The thickness from intima to media of the anterior or posterior wall was detected on common carotid artery, carotid sinus, common iliac artery, femoral artery and brachial artery through broadband probe in the rated range during the diastolic period. Results 236 patients with type 2 diabetes mellitus were examined by CDU. 85(36%) of patients suffered from one or more angiopathy. There were 143 macrovascular lisions in all. The rates of vascular lesions occured in femoral artery and common iliac artery were significantly higher than that in common carotid artery, carotid sinus (CS) and brachial artery (P<0.01). The appearence of two or more vessel lesions was much higher than that of single vessel lesion (P<0.01). Angiopathy occured frequently in posterior wall and branch of vessel (includeing CS). Conclusions CDU can diagnose atherosclerosis and other angiopathies immediately and noninvasively. Multiple blood vessels measurement can help the diagnosis of type 2 diabetes mellitus and is beneficial to the therapy.