超声评价初诊2型糖尿病患者颈总动脉内-中膜厚度及血流动力学与糖化血红蛋白的相关性

目的 应用高频超声评价初诊2型糖尿病（T2DM）患者颈总动脉内-中膜厚度（IMT）及血流动力学与不同水平糖化血红蛋白（HbA1c）的相关性.方法 选取符合2010年糖尿病新标准诊断的初诊T2DM患者82例,根据HbA1c水平将其分为A组45例（HbA1c均〈6.5%）和B组37例（HbA1c均≥6.5%）.应用高频超声测量两组患者及50例健康成人（C组）双侧颈总动脉IMT、动脉斑块及血流动力学参数,包括搏动指数（PI）和阻力指数（RI）.结果 A、B组颈总动脉IMT均高于C组（P 〈 0.05）,且B组IMT高于A组（P 〈 0.05）.B组斑块发生率和斑块积分均高于A、C组（P 〈 0.05）,且A组斑块发生率和斑块积分与C组比较差异无统计学意义.A、B组颈总动脉血流参数PI和RI均稍高于C组（P 〈 0.05）,且A、B组间PI和RI比较差异无统计学意义.结论 超声可准确评估初诊T2DM患者颈总动脉IMT、斑块形成及血流动力学特征与HbA1c水平的相关性,对初诊T2DM患者颈动脉并发症的早期诊断有重要意义.

Evaluation of the correlation between glycosylated hemoglobin and carotid intima-media thickness and hemodynamics of newly diagnosed type 2 diabetes mellitus patients by ultrasonography

Objective To explore the correlation between different levels of glycosylated hemoglobin （HbAlc） and carotid intima-media thickness （IMT） and hemodynamics of newly diagnosed type 2 diabetes mellitus （T2DM） patients by high- frequency ultrasonography. Methods Eighty-two newly diagnosed T2DM patients were divided into group A（ 45 cases, HbA1c〈 6.5%） and group B（37 cases, HbA1c≥6.5%） according to levels of HbAlc, 50 healthy volunteers were in the group C. Their IMT, arterial plaque and hemodynamics parameters, including pulsatility index （PI） and resistance index （RI） of both carotid arteries were measured by high-frequency ultrasonography. Results IMT of groups A and B were significantly higher than that of group C （P 〈 0.05 ）, and the IMT of group B was higher than that of group A（P 〈 0.05）. The incidence of arterial plaque and plaque score in group B were significantly higher than those in groups A and C （P 〈 0.05 ）, while there was no different between group A and group C. PI and RI of common carotid artery in group A and group B were higher than those of group C（P 〈 0.05）, while there was no significant difference between group A and group B. Conclusion High-frequency ultrasonography can be used to evaluate the IMT, arterial plaque and hemodynamics of carotid arteries of newly diagnosed T2DM patients with different levels of HbAlc, and it also has important value in early diagnosis of carotid complication due to T2DM.