经颅多普勒(TCD)在2型糖尿病患者脑血管病变诊断中的应用

目的通过经颅多普勒(TCD)检查,比较糖尿病人与健康对照组脑血管各项参数的情况,从而探讨TCD在2型糖尿病患者脑血管病变诊断中的应用。方法选择92例血压正常的2型糖尿病患者作为病例组研究对象,100名血压、血糖、血脂正常的健康体检者作为对照组,通过TCD检查两组研究对象的大脑中动脉(MCA),大脑前动脉(ACA),大脑后动脉(PCA)、椎动脉(VA),基底动脉(BA)的血流速度(Vs)、舒张期血流速度(Vd)、平均血流速度(Vm)、搏动指数(PI)、阻力指数(RI)几项指标,根据TCD检查情况,将脑血管状态分为正常、脑血管痉挛、脑动脉硬化、脑动脉狭窄、脑供血不足5种状态,比较两组研究对象脑血管异常率及PI、RI的差异。结果糖尿病组患者脑血管异常率为88.04%,对照组异常率为0.08%,差异具有统计学意义(χ2=123.5,P﹤0.01)。两组研究对象的大脑中动脉(MCA)、大脑前动脉(ACA)、大脑后动脉(PCA)、椎动脉(VA)、基底动脉(BA)的搏动指数(PI)及阻力指数(RI)差异也具有统计学意义。结论 TCD能够检测到糖尿病患者脑血管的异常改变,可反映糖尿病患者的脑血管病变,为临床诊疗提供参考。

Application of TCD in diagnosis of cerebrovascular diseases among patients with type 2 diabetes

OBJECTIVE With TCD diagnosis,to compare the indexes of cerebrovascular of patients with type 2 diabetes and health controls to explore the TCD in diagnosis of cerebrovascular disease of patients with type 2 diabetes.METHODS A total of 92 patients with type 2 diabetes whose blood pressure was normal were selected as patients,and healthy residents with normal blood pressure,blood sugar and blood fat were served as controls.The TCD was used to detect MCA,ACA,PCA,VA,Vs of BA,Vd,Vm,PI and RI,and the status of cerebrovascular were divided into normal,cerebral angiospasm,cerebral arteriosclerosis,cerebral arterial stenosis and chronic cerebral circulation insufficiency,and compared abnormal rate,PI and RI of the two groups.RESULTS The abnormal rate of the patients was 88.04%,and the rate of the controls were 0.08%.There was a significant difference between the two groups(χ2 = 123.5,P﹤0.01).MCA,ACA,PCA,VA,BA,PI and RI showed significant differences between the two groups.CONCLUSION TCD could detect the abnormal changes of type 2 diabetes,and could reflect the cerebrovascular disease and provide reference for clinical diagnosis.