超声造影在2型糖尿病患者骨骼肌微循环病变评估中的应用

目的 通过超声造影（contrast-enhanced ultrasound,CEUS）评估小腿三头肌的微循环灌注情况，探讨CEUS在2型糖尿病（type 2 diabetes mellitus,T2DM）微血管病变评估中的应用价值。方法 收集2020年8月至2023年1月在温州医科大学附属第二医院内分泌科住院治疗的T2DM患者51例，分为单纯T2DM组（n=15）、T2DM微循环病变组（n=36），记录每位患者的糖化血红蛋白（hemoglobin A1c,Hb A1c）和胰岛素抵抗指数（homeostatic model assessment for insulin resistance,HOMA-IR）。CEUS观察小腿三头肌的造影情况，获取定量造影指标区域增强强度（enhanced intensity,PI-BI）和区域达峰时间（regional peak time,TTP-AT），并进行组间对比分析。结果 T2DM微变组的Hb A1c及HOMA-IR高于单纯T2DM组（P<0.05）。T2DM微变组腓肠肌内侧头（musculi gastrocnemii,MG）、腓肠肌外侧...

Application of contrast-enhanced ultrasound in evaluating skeletal muscle microcirculation in patients with type 2 diabetes mellitus

Objective To explore the value of contrast-enhanced ultrasound (CEUS) in the assessment of diabetic microangiopademia through evaluating microcirculation perfusion of triceps surae muscle by CEUS. Method Totally 51 patients with type 2 diabetes mellitus (T2DM) admitted in our hospital between August 2020 and January 2023 were collected, including 15 pure T2DM patients and 36 T2DM patients complicated with microcirculatory disturbance (T2DM+CM). Each patient’s hemoglobin A1c (HbA1c) and homeostatic model assessment for insulin resistance (HOMA-IR) were recorded. After getting enhanced intensity (PI-BI) and regional peak time (TTP-AT) by CEUS, comparative analysis between groups was conducted. Results The levels of HbA1c and HOMA-IR in T2DM+CM group were higher than those in pure T2DM group (P<0.05). TTP-AT in T2DM+CM group were longer than that in pure T2DM group of all muscles musculi gastrocnemii (MG), laterale musculi gastrocnemi (LG), soleus (SOL) and triceps surae muscle’s junction region) (P<0.05). The TTP-AT of SOL was longest in both groups, followed by LG, and MG (P<0.05). The PI-BI had no significant difference among MG, LG and SOL in pure T2DM group. The PI-BI of MG was higher than that of SOL in the T2DM+CM group (P<0.05). TTP-AT of triceps surae muscle’s junction region had significant positive association with both HbA1c and HOMA-IR (P<0.05). Conclusion The TTP-AT of triceps surae muscle measured by CEUS is a new indicator for evaluating microangiopathopathy in T2DM patients.