超声对2型糖尿病患者颈部及下肢动脉病变的诊断价值

目的 探讨超声对2型糖尿病患者颈部及下肢动脉病变的诊断价值.方法选取2型糖尿病患者127例（糖尿病组）,其中检查颈部动脉56例,检查下肢动脉71例;另选同期年龄相近非糖尿病患者151例（对照组）,其中检查颈部动脉68例,检查下肢动脉83例,比较分析两组患者血管形态、血管壁内-中膜厚度（IMT）、有无斑块、管腔狭窄或闭塞及血流动力学改变情况.结果糖尿病组颈部及下肢动脉IMT明显增厚,管腔的硬化斑块、狭窄及闭塞的发生率明显高于对照组,两组比较差异有统计学意义（P〈0.05）.颈动脉斑块以颈总动脉分叉处及颈内动脉最多见;糖尿病组所致下肢动脉粥样硬化多呈弥漫性,以双侧及多节段性分布,管腔狭窄、闭塞以腘动脉以下远端的足背动脉、胫前动脉、胫后动脉受累最为明显.而对照组病变多为单发,局灶性.结论 超声对2型糖尿病患者颈部及下肢动脉病变的早期诊断,可为临床预防和治疗2型糖尿病提供依据.

Value of ultrasound in diagnosis of neck and lower extremity artery disease in patients with type 2 diabetes mellitus

Objective To explore the value of ultrasound in diagnosis of neck and lower extremity artery disease in patients with type 2 diabetes mellitus（DM）. Methods One hundred and twenty-seven patients with type 2 DM were divided into two groups（56 cases of carotid artery group, 71 cases of lower extremity arterial group）, 151 patients without type 2 DM were enrolled as control group （68 cases of carotid artery group, 83 cases of lower extremity arterial group）. Their vascular morphology, intima-media thickness （IMT）, with or without plaque, stenosis or occlusion and hemodynamie changes were analyzed. Results The IMT of neck and lower extremity arteries in type 2 DM group became thicker, the occurrence rate of the plaque, stenosis and occlusion were significantly higher than those in control group, there was significant difference between two groups （ P〈0.05 ）. Carotid artery plaque in the carotid artery bifurcation and internal carotid artery were the most common, lower limb atherosclerosis in type 2 DM group was mostly diffuse, bilateral and multi-segmental, stenosis and occlusion of the dorsal artery of the foot , anterior tibial artery, posterior tibial artery involvement were most obvious, while the control group lesions mostly were single and focal. Conclusion Early diagnosis of neck and lower extremity arterial disease of type 2 DM patients with ultrasound can provide information for clinical prevention and early treatment of type 2 DM.