多种无创检测方法评价糖尿病患者早期动脉硬化

目的多种无创检测方法联合评价2型糖尿病(DM)患者早期动脉硬化情况。方法无并发症的DM患者30例,对照组27例,行颈动脉内膜中层厚度(IMT)、踝臂指数(ABI)、肱踝脉搏波传导速度(baPWV)、压力波增强指数(AI)及血管回声跟踪技术(ET技术)检查,比较两组动脉硬化参数及其相关性。结果 DM组及对照组IMT、ABI均在正常范围,且差异无统计学意义(均为P0.05);左右两侧baPWV[(1449±232)cm/s比(1291±171)cm/s,(1452±222)cm/s比(1280±178)cm/s;P0.01]及ET技术中压力-应变弹性系数(Ep)[(137±51)kPa比(101±34)kPa,P0.01]、硬化参数(β)[(10.6±4.2)比(8.2±2.7),P0.05]、单点脉搏波传导速度(PWVβ)[(7.0±1.2)m/s比(6.1±1.0)m/s,P0.01]在DM组均明显高于对照组。DM组动脉硬化的发生率较对照组升高[67%(20/30)比26%(7/27),P0.01];Ep、PWVβ分别与左右两侧baPWV呈正相关。结论 DM患者动脉硬化发生率较对照组明显增加;ET技术中Ep、β、PWVβ与baPWV均可敏感地反映糖尿病患者早期动脉硬化。

Evaluation of early arteriosclerosis in patients with diabetes mellitus by several non-invasive methods

Objective To evaluate early arteriosclerosis in patients with type 2 diabetes mellitus （T2DM） by several non-invasive methods. Methods A total of 30 T2DM patients without complications and 27 control people were enrolled. The parameters of arteriosclerosis,including carotid intima-media thickness （ [MT）, ankle brachial index （ABI） , brachial-ankle pulse wave velocity （baPWV） ,augmentation index （AI） and echo-tracking technique （ET） were compared between the two groups. Restdts IMT and ABI in two groups were within normal range and there were no statistical differences between two groups. Pressure-strain elastic modulus （Ep） [ （ 137 ±51 ） kPa vs. （ 101±34 ） kPa, P 〈 0. 01 ], stiffness parameter （β） [ （10. 6 ± 4. 2 ） vs. （8. 2 ± 2. 7）, P 〈 0. 05 ] and one-point pulse wave velocity（PWVβ） [ （7. 0 ± 1.2）m/svs. （6.1 ±1.0） m/s,P〈0.01] in ET and left baPWV[（1449±232） cm/s vs. （1291±171）cm/s,P〈 0.01 ] ,right baPWV [ （ 1452 ±222）cm/s vs. （ 1280 ± 178） cm/s,P 〈0.01 ]in T2DM group were significantly higher than those in control group. Incidence of arteriosclerosis in T2DM group was statistically higher [67% （20/30） vs. 26% （7/ 27） ,P 〈 0. 01 ]. Ep and PWVβ were positively correlated with baPWV. Conclusions Incidence of arteriosclerosis was higher in T2DM patients even without complications ;Ep,βand PWVβ in echo-tracking technique and baPWV appear to be sensitive methods for detection of early arteriosclerosis.