彩超联合踝、趾臂指数诊断2型糖尿病下肢动脉病变的应用

目的 探讨彩超联合踝臂指数（ABI）、趾臂指数（TBI）检测2型糖尿病（T2DM）患者下肢动脉病变（PAD）的应用价值.方法 应用彩超及ABI、TBI检测方法,分别对127例T2DM患者进行测定,根据有无血压、血脂异常分单纯T2DM组62例,T2DM＋合并症组65例,并选取同期门诊健康体检者60例为对照组.结果 T2DM组及其合并症组的PAD超声检出率均高于对照组,T2DM＋合并症组的PAD超声检出率高于T2DM组;T2DM组以ABI≤0.9为标准,3组间PAD的检出率差异有统计学意义（P＜0.05）;超声与单纯ABI检测结果比较,PAD检出率差异有统计学意义（P＜0.05）,但与ABI联合TBI检测结果比较,PAD检出率差异无统计学意义（P＞0.05）.糖尿病PAD随患者病程、年龄的增加而加重,并受高血压、高脂血症等合并症的影响.结论 ABI、TBI检测具有无创、简单、可重复性强的特点,结合彩色多普勒血管超声可早期诊断T2DM患者PAD.

Application of ABI,TBI and CDUS in diagnosis for lower extremity arterial lesion caused by type II diabetes

Objective To investigate the clinical significance through ankle branchialindex （ABI）, toe branchial index （TBI） and color Doppler ultrasound （CDUS） for diagnosing peripheral arterial lesion caused by type II diabetes. Methods The ABI, TBI and CDUS were measured in 127 T2DM patients. 127 T2DM patients were divided into T2DM group （n = 62 ）, T2DM with complication group （ n = 65 ） and control group （ n = 60）. Results Based on the criterion ABI 〈 0.9, the difference of PAD ultrasonic detection rate presented significant decrease （ P 〈 0.05 ）. Compared with inspection results by single ABI and CDUS, the difference of PAD detection rate presented obviously （ P 〈0.01 ） ;However with inspection results by both ABI and TBI, the difference of PAD detection rate presen ted no statistical significance （ P 〉 0.05 ）. As the course of disease and age become longer, the patient＇ s PAD was deteriorating and in-fluenced by hypertension and hyperlipaemia. The more serious PAD, the lower values of ABI and TBI. Conclusion The inspection of ABI and TBI are noninvasive simple and repetitiveness method. It is helpful for early diagnosis of T2DM with PAD.