超声彩色脉搏波技术在定量评价2型糖尿病患者颈动脉弹性变化中的应用

目的探讨超声彩色脉搏波(UFPWV)技术在定量评价2型糖尿病患者颈动脉血管管壁弹性变化中的应用价值。方法回顾性研究。纳入2018年7月—2019年3月蚌埠医学院第一附属医院收治的97例2型糖尿病患者为观察组,其中男47例、女50例,年龄20~74(46.6±9.3)岁;根据颈动脉内中膜厚度(IMT)将观察组分为颈动脉粥样斑块组(A组)、颈动脉内中膜增厚组(B组)和颈动脉内中膜正常组(C组),依据下肢动脉有无斑块将C组分为下肢动脉斑块组(C1组)、下肢动脉无斑块组(C2组)。选取2017年12月—2018年12月在蚌埠医学院第一附属医院体检中心血糖及颈动脉IMT正常的健康体检者64人为对照组,其中男25人、女39人,年龄20~74(44.3±12.0)岁。运用UFPWV采集脉搏波速度(PWV),计算颈动脉收缩早期PWV(PWV-BS)及收缩晚期PWV(PWV-ES),分析各项参数组间的差异。结果观察组中,A组颈动脉PWV-BS、PWV-ES分别为(9.51±1.25)m/s、(10.79±1.64)m/s,B组分别为(8.47±0.91)m/s、(9.81±1.05)m/s,C组分别为(7.97±0.77)m/s、(9.07±0.74)m/s,对照组颈动脉PWV-BS、PWV-ES分别为(6.10±1.00)m/s、(7.40±1.20)m/s,A组、B组、C组及对照组间颈动脉PWV-BS、PWV-ES测量值依次降低,差异均有统计学意义(P值均<0.05)。C组中,C1组颈动脉PWV-BS、PWV-ES分别为(7.83±0.85)m/s、(8.82±0.59)m/s,C2组分别为(8.14±0.64)m/s、(9.34±0.79)m/s,C1组PWV-ES显著高于C2组,差异有统计学意义(t=3.402,P<0.01),而两组间PWV-BS的差异无统计学意义(P>0.05)。结论UFPWV技术可定量评价2型糖尿病患者颈动脉弹性变化,并可通过PWV-ES的改变评估颈动脉形态学正常的患者动脉粥样硬化的进展程度,对临床诊疗具有一定意义。

Application value of the ultraphonic ultrafast pulse wave velocity technique for the quantitative evaluation of the carotid elastic changes in patients with type 2 diabetes mellitus

Objective This study aimed to explore the application value of the ultraphonic ultrafast pulse wave velocity (UFPWV) technique in the quantitative evaluation of the carotid vascular wall elasticity changes of patients with type 2 diabetes mellitus.Methods This retrospective study included the imaging data of 97 cases of type 2 diabetes mellitus admitted at the First Affiliated Hospital of Bengbu Medical College in Anhui Province from July 2018 to March 2019 as the observation group. The cases consisted of 47 males and 50 females aged between 20 and 74 (46.6±9.3) years. In accordance with the carotid intima-media thickness (IMT), the observation group was divided into carotid atherosclerotic plaque group(groups A), carotid IMT thickening group(group B), and IMT normal group(group C). Group C was divided further into lower extremity atherosclerotic plaque group(group C1) and lower extremity arteries without plaque group(group C2) on the basis of the lower extremity arteries with or without plaque. A total of 64 volunteers with normal blood glucose and IMT were selected as the control group. The control group included 25 males and 39 females aged between 20 and 74 (44.3±12.0). The pulse wave velocity (PWV) was acquired via the ultrafast pulse wave technique, which included the beginning and ending of the systole (BS and ES, respectively), and the differences between the parameters were analyzed.Results In the observation group, the PWV-BS and the PWV-ES values were (9.51±1.25)and (10.79±1.64)m/s, respectively, in group A; (8.47±0.91) and (9.81±1.05) m/s, respectively, in group B; and (7.97±0.77) and (9.07±0.74) m/s, respectively, in group C. The PWV-BS and the PWV-ES values in the control group were (6.10±1.00) and 7.40±1.20 m/s, respectively. The results of carotid artery PWV-BS and PWV-ES in groups A, B, and C and the control group gradually decreased, and the differences were statistically significant (all P values<0.05). Within group C, the PWV-BS and the PWV-ES values were (7.83±0.85) and (8.82±0.59) m/s, respectively, in group C1 and (8.14±0.64) and (9.34±0. 79) m/s, respectively, in group C2. The PWV-ES in group C1 was significantly higher than that in group C2 (t=3.402, P<0.01). By contrast, no statistical significance on the PWV-BS values existed between the two groups (P>0.05).Conclusions The UFPWV technique can be used to evaluate the carotid elastic changes in patients with type 2 diabetes mellitus quantitatively and can assess the progression of atherosclerosis in patients with normal carotid artery morphology through the changes in PWV-ES values. This technique is significant for clinical diagnosis and treatment.