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目的探讨彩色多普勒超声检查对2型糖尿病(T2DM)患者下肢动脉粥样硬化病变的早期诊断价值,为临床检查方式的选取提供依据。方法选择2016年1月至2016年12月福建省福州市第二医院收治的80例T2DM患者作为研究对象,所有患者均有不同程度的下肢血管病变,设为研究组,选择同期体检的健康人员80例作为对照组,两组患者均进行下肢动脉(股动脉、腘动脉、胫后动脉、足背动脉)检查,获取多普勒超声参数,包括血流内径、血流速度、内—中膜厚度(IMT)、阻力指数(RI),同时对血管壁进行观察。结果观察组管腔内膜光滑率为7.50%,明显低于对照组86.25%,差异有统计学意义(P<0.01);观察组管腔内膜不光滑有斑块比例为71.25%,明显高于对照组3.75%,差异有统计学意义(P<0.01)。观察组下肢动脉(股动脉、腘动脉、胫后动脉、足背动脉)血流内径明显低于对照组(P<0.05),血流速度、IMT、RI均明显高于对照组(P<0.05)。观察组患者经下肢动脉超声检查显示管腔存在斑块57例,下肢动脉斑块由高到低分布依次为足背动脉30例(52.63%)、胫后动脉23例(40.35%)、腘动脉20例(35.09%)、股动脉12例(21.05%),其中14例患者斑块存在于2个或以上下肢动脉中。结论彩色多普勒超声能够对早期诊断T2DM患者下肢动脉粥样硬化病变做出正确诊断,具有诊断符合率高、操作简单、安全无创的优点,可作为首选的检查方式。
Objective To investigate the value of color Doppler ultrasonography in the early diagnosis of atherosclerotic lesions of lower extremities in type 2 diabetes mellitus (T2DM) patients and provide basis for the selection of clinical examination methods. Methods From January 2016 to December 2016, 80 patients with T2DM admitted to the Second Hospital of Fuzhou, Fujian Province were selected as study subjects. All patients had varying degrees of lower extremity vascular disease. The study group was selected as healthy subjects Eighty patients served as the control group. The lower extremity arteries (femoral artery, popliteal artery, posterior tibial artery, dorsalis pedis artery) were examined in both groups, and the parameters of Doppler ultrasound including blood flow diameter, blood flow velocity, Thickness (IMT), resistance index (RI), while the vessel wall was observed. Results The luminal smoothness of the observation group was 7.50%, which was significantly lower than that of the control group (86.25%) (P <0.01). In the observation group, the luminal plaque area was 71.25% In the control group 3.75%, the difference was statistically significant (P <0.01). The diameter of blood flow in the lower extremity arteries (femoral artery, popliteal artery, posterior tibial artery and dorsalis pedis artery) in the observation group was significantly lower than that in the control group (P <0.05), and the blood flow velocity, IMT and RI were significantly higher than those in the control group ). In the observation group, 57 cases showed plaque in the lumen by ultrasonography of lower extremity artery. The distribution of lower plaque in the observation group was 30 cases (52.63%) of the dorsalis pedis artery, 23 cases (40.35%) of the posterior tibial artery, There were 20 cases (35.09%) and 12 femoral arteries (21.05%), of which 14 cases had plaque in 2 or more lower extremity arteries. Conclusion Color Doppler ultrasound can diagnose the lower extremity atherosclerotic lesion in early diagnosis of T2DM patients. It has the advantages of high coincidence rate, simple operation and safe non-invasive diagnosis, which can be used as the first choice of examination.