高频彩色多普勒超声诊断糖尿病合并高血压患者颈动脉粥样硬化病变的价值

目的探讨高频彩色多普勒超声诊断2型糖尿病(DM)合并高血压(EH)患者颈动脉粥样硬化的价值。方法选取2009年1月～2011年8月我院收治的2型糖尿病患者200例,分为两组,92例单纯2型糖尿病患者为DM组和108例2型糖尿病合并高血压患者为DM+EH组;另选100例健康体检者作为对照组。采用高频彩色多普勒超声检测颈动脉内-中膜厚度(IMT)和硬化斑块,对颈动脉粥样硬化病变和狭窄的发生率进行对比分析。结果①DM+EH组及DM组颈动脉IMT均高于对照组,DM+EH组颈动脉IMT均高于DM组,差异均有高度统计学意义(均P<0.01)。②DM+EH组、DM组颈动脉斑块检出率均明显高于对照组,差异均有高度统计学意义(均P<00.1);DM+EH组患者的颈动脉斑块检出率高于DM组,差异有统计学意义(P<0.05);颈动脉粥样硬化斑块主要出现在颈动脉分叉处及颈内动脉。③DM+EH组患者颈动脉狭窄的总检出率高于DM组,差异有统计学意义(P<0.05);狭窄≥50%的检出率DM+EH组及DM组比较,差异无统计学意义(P>0.05)。结论 2型糖尿病合并高血压患者颈动脉粥样硬化的发病率明显增高,高频彩色多普勒超声诊断颈动脉粥样硬化为临床的早期防治提供了可靠的参考依据。

Diagnosis value of high-frequency color doppler ultrasound of the carotid atherosclerosis lesions in diabetic patiens with hypertension

Objective To explore the value of high-frequency color doppler ultrasound in diagnosis of the carotid atherosclerosis lesions in type 2 diabetic patients with hypertension.Methods Two hundred patients with type 2 diabetic mellitus from January 2009 to August 2011 in our hospital were divided into two groups,92 cases with type 2 diabetic mellitus were assigned to DM group and 108 cases of diabetic mellitus with hypertension were assigned to DM＋EH group.One hundred healthy subjects were enrolled as control group.The intima-media thickness（IMT） and the carotid artery plaques were measured by high-frequency color doppler ultrasound.The occurrence rates of carotid artery atherosclerosis lesions and stenosis were compared and analyzed in three groups.Results ①The IMT of carotid artery in DM＋EH group and DM group were all significantly higher than those in control group,the IMT of carotid artery in DM＋EH group was higher than that in DM group,the differences were all statistically significant（all P 0.01）.②The detection rates of carotid artery plaques in DM＋EH group and DM group were significantly higher than those in control group,the differences were all statistically significant（all P 0.01）.The detection rates of carotid artery plaques in DM＋EH group was significantly higher than that in DM group,the difference was statistically significant（P 0.05）.The carotid atherosclerotic plaques were mainly found in the carotid bifurcation and internal carotid artery.③The total detection rate of carotid artery stenosis in DM＋EH group was significantly higher than that in DM group,the difference was statistically significant（P 0.05）.The difference of detection rate ≥ 50% stenosis was not statistically significant between the two groups（P 0.05）.Conclusion The incidence rate of carotid atherosclerosis lesions in type 2 diabetic patiens with hypertension has a obvious increase.High-frequency color doppler ultrasound in diagnosis of carotid atherosclerosis lesions can provide a reliable reference for clinical early prevention and control.