高频超声技术检测2型糖尿病患者指、趾尖动脉血流参数及其在早期血管病变中的筛查价值
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摘要
目的分析高频超声技术检测2型糖尿病(T2DM)患者指、趾尖动脉血流参数及其在早期血管病变中的筛查价值。方法选取2016年3月~2017年3月唐山市工人医院分院(以下简称"我院")90例T2DM患者为T2DM组,其中患病时间1~3年48例,>3~9年22例,>9~<16年11例,≥16年9例。选择同期于我院体检健康者90名为对照组。通过高频超声技术检测两组指、趾尖动脉血流参数的情况。结果 T2DM组患病时间为>3~9年、>9~<16年及≥16年的患者指尖动脉阻力指数明显高于对照组,血流量显著低于对照组,差异均有统计学意义(P<0.05);T2DM组患病时间>9~<16年和≥16年的患者指尖末梢动脉血管内径均明显低于对照组,差异均有统计学意义(P<0.05);T2DM组患病时间为>3~9年、>9~<16年、≥16年的患者趾尖末梢动脉的阻力指数明显高于对照组,血管内径与血流量均明显低于对照组,差异均有统计学意义(均P<0.05)。结论利用高频超声技术能够有效检测T2DM患者的指、趾尖动脉血流参数的情况,有助于筛查患者早期血管病变,故此有着重要的评估价值。
Objective To analyze the detection of high frequency ultrasonography in blood flow parameters of finger,toe tip artery and screening value of early vascular disease in patients with type 2 diabetes mellitus(T2DM). Methods From March 2016 to March 2017, 90 cases of T2DM in the Workers′ Hospital of Tangshan City( "our hospital" for short) were selected as the T2DM group, among them, there were 48 cases with the disease duration of 1-3 years, 22 cases with > 3-9 years, 11 cases with >9-<16 years, and 9 cases with ≥ 16 years. Ninety healthy subjects in our hospital were selected as the control group at the same period. The blood flow parameters of finger and toe tip artery were detected by high frequency ultrasonography in the each group. Results The resistance index of finger tip artery in patients with the disease duration of >3-9 years, >9-<16 years and ≥ 16 years in the T2DM group were significantly higher than those in the control group, and the blood flow were significantly lower than those in the control group, the differences were statistically significant(P < 0.05). The finger tip peripheral arterial vascular diameter for patients with the disease duration of >9-<16 years and ≥ 16 years in the T2DM group were significantly lower than those in the control group, the differences were statistically significant(P < 0.05). The resistance index of toe tip artery for patients with the disease duration >3-9 years, >9-<16 years and ≥ 16 years in the T2DM group were significantly higher than those in the control group, and the vascular diameter and blood flow were significantly lower than those in the control group, the differences were statistically significant(P < 0.05). Conclusion Using high frequency ultrasonography can effectively detect the blood flow parameters of finger and toe tip artery in patients with T2DM, which can help to screen the early vascular lesion, so it has important assessment value.
Objective To analyze the detection of high frequency ultrasonography in blood flow parameters of finger,toe tip artery and screening value of early vascular disease in patients with type 2 diabetes mellitus(T2DM). Methods From March 2016 to March 2017, 90 cases of T2DM in the Workers′ Hospital of Tangshan City( "our hospital" for short) were selected as the T2DM group, among them, there were 48 cases with the disease duration of 1-3 years, 22 cases with > 3-9 years, 11 cases with >9-<16 years, and 9 cases with ≥ 16 years. Ninety healthy subjects in our hospital were selected as the control group at the same period. The blood flow parameters of finger and toe tip artery were detected by high frequency ultrasonography in the each group. Results The resistance index of finger tip artery in patients with the disease duration of >3-9 years, >9-<16 years and ≥ 16 years in the T2DM group were significantly higher than those in the control group, and the blood flow were significantly lower than those in the control group, the differences were statistically significant(P < 0.05). The finger tip peripheral arterial vascular diameter for patients with the disease duration of >9-<16 years and ≥ 16 years in the T2DM group were significantly lower than those in the control group, the differences were statistically significant(P < 0.05). The resistance index of toe tip artery for patients with the disease duration >3-9 years, >9-<16 years and ≥ 16 years in the T2DM group were significantly higher than those in the control group, and the vascular diameter and blood flow were significantly lower than those in the control group, the differences were statistically significant(P < 0.05). Conclusion Using high frequency ultrasonography can effectively detect the blood flow parameters of finger and toe tip artery in patients with T2DM, which can help to screen the early vascular lesion, so it has important assessment value.
引文
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[14]王晓慧,张宇虹,苏本利,等.高频超声检测2型糖尿病周围神经病变患者足部肌肉萎缩[J].中国医学影像技术,2013,29(2):276-279.
[15]Chan HT,Yiu KH,Wong CY,et al.Increased dietary fruit intake was associated with lower burden of carotid atherosclerosis in Chinese patients with Type 2 diabetes mellitus[J].Diabet Med,2013,30(1):100-108.
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[17]Shah RV,Altman RK,Park MY,et al.Usefulness of hemoglobin A(1c)to predict outcome after cardiac resynchronization therapy in patients with diabetes mellitus and heart failure[J].Am J Cardiol,2012,110(5):683-688.
[18]彤丹,闫玮.2型糖尿病患者颈动脉内-中膜厚度与血管内皮功能的超声评价及其相关性研究[J].中华危重症医学杂志:电子版,2014,7(2):123-125.
[19]Zhou N,Yu QJ,Si R,et al.Postprocedure administration of insulin in canine autologous vein grafting:a potential strategy to attenuate intimal hyperplasia[J].J Cardiovasc Pharmacol,2010,56(4):402-412.
[20]张广颖,罗文英,祖永刚,等.高压氧联合西洛他唑对糖尿病足患者微血管病变的影响[J].西部医学,2017,29(10):1397-1400,1405.
[21]段雨函,李至.血栓前体蛋白和抗凝血酶-Ⅲ在糖尿病微血管病变患者中的检测及临床意义[J].临床和实验医学杂志,2017,16(7):678-680.
[22]黄凌宁,罗莉.糖尿病足早期筛查与诊断技术进行社区推广应用的价值[J].中国老年学杂志,2014,34(13):3550-3551.
[23]Li L,Yu H,Zhu J,et al.The combination of carotid and lower extremity ultrasonography increases the detection of atherosclerosis in type 2 diabetes patients[J].J Diabetes Complications,2012,26(1):23-28.
[24]陈鸣.彩色多普勒超声对诊断早期糖尿病肾病的价值[J].中国临床医学影像杂志,2012,23(2):88-90.
[25]Da SCA,Ribeiro JP,Canto JC,et al.High-intensity aerobic training improves endothelium-dependent vasodilation in patients with metabolic syndrome and type 2 diabetes mellitus[J].Diabetes Res Clin Pract,2012,95(2):237-245.
[26]严禹.彩色多普勒超声在诊断糖尿病下肢血管病变中的价值研究[J].中国医药科学,2005,17(9):617-619.
[2]赵峰,夏良华,王洪兴,等.18 MHz高频超声技术检测社区T2DM患者足背动脉血管病变[J].河北医学,2016,22(4):546-549.
[3]Jeong IK,Kim SG,Cho DH,et al.Impact of carotid atherosclerosis detection on physician and patient behavior in the management of type 2 diabetes mellitus:a prospective,observational,multicenter study[J].BMC Cardiovasc Disord,2016,16(1):220.
[4]Brzezinski RY,Berliner S,Shenhar-Tsarfaty S.Letter by Brzezins-kietal Regarding article,“prediabetes and type2 diabetes are associated with generalized microvascular dysfunction:the Maastricht study”[J].Circulation,2017,135(14):e860.
[5]Tsuda K.Letter by Tsuda Regarding articles,“prediabetes and type 2 diabetes are associated with generalized microvascular dysfunction:the Maastricht study”[J].Circulation,2017,135(14):e858.
[6]许娜,郭淑芹,张云良,等.2型糖尿病患者血清SFRP5、脂联素水平与尿蛋白的关系临床研究[J].中国中西医结合肾病杂志,2017,18(2):148.
[7]Zhang Y,Sun X,Icli B,et al.Emerging roles for micro RNAs in diabetic microvascular disease:novel targets for therapy[J].Endocr Rev,2017,38(2):145.
[8]Asal NJ,Wojciak KA.Effect of cilostazol in treating diabetes-associated microvascular complications[J].Endocrine,2017,56(2):240.
[9]王枫,钱雪梅,赵玉武,等.神经肌电图检查在糖尿病早期周围神经病变诊断中临床价值[J].现代仪器与医疗,2013,19(4):40-42.
[10]蒋蓓.高频超声对2型糖尿病颈动脉病变的检测价值[J].江苏医药,2016,42(16):1838-1839.
[11]Zheng TP,Liu YH,Yang LX,et al.Increased plasma dipeptidyl peptidase-4 activities are associated with high prevalence of subclinical atherosclerosis in Chinese patients with newly diagnosed type 2 diabetes:a cross-sectional study[J].Atherosclerosis,2015,242(2):580-588.
[12]管衍,刘志明,李光伟.50岁以上糖尿病人群周围动脉闭塞性疾病相关因素分析[J].中华医学杂志,2007,87(1):23.
[13]徐秀梅,穆玉明,翟虹,等.高血压合并糖尿病患者内皮功能、血流参数、内中膜厚度与动脉硬化的关系[J].中国老年学杂志,2013,33(19):4671-4673.
[14]王晓慧,张宇虹,苏本利,等.高频超声检测2型糖尿病周围神经病变患者足部肌肉萎缩[J].中国医学影像技术,2013,29(2):276-279.
[15]Chan HT,Yiu KH,Wong CY,et al.Increased dietary fruit intake was associated with lower burden of carotid atherosclerosis in Chinese patients with Type 2 diabetes mellitus[J].Diabet Med,2013,30(1):100-108.
[16]董琪,李全民.糖尿病周围神经病变发病机制的研究进展[J].现代仪器与医疗,2015,21(2):20-22,34.
[17]Shah RV,Altman RK,Park MY,et al.Usefulness of hemoglobin A(1c)to predict outcome after cardiac resynchronization therapy in patients with diabetes mellitus and heart failure[J].Am J Cardiol,2012,110(5):683-688.
[18]彤丹,闫玮.2型糖尿病患者颈动脉内-中膜厚度与血管内皮功能的超声评价及其相关性研究[J].中华危重症医学杂志:电子版,2014,7(2):123-125.
[19]Zhou N,Yu QJ,Si R,et al.Postprocedure administration of insulin in canine autologous vein grafting:a potential strategy to attenuate intimal hyperplasia[J].J Cardiovasc Pharmacol,2010,56(4):402-412.
[20]张广颖,罗文英,祖永刚,等.高压氧联合西洛他唑对糖尿病足患者微血管病变的影响[J].西部医学,2017,29(10):1397-1400,1405.
[21]段雨函,李至.血栓前体蛋白和抗凝血酶-Ⅲ在糖尿病微血管病变患者中的检测及临床意义[J].临床和实验医学杂志,2017,16(7):678-680.
[22]黄凌宁,罗莉.糖尿病足早期筛查与诊断技术进行社区推广应用的价值[J].中国老年学杂志,2014,34(13):3550-3551.
[23]Li L,Yu H,Zhu J,et al.The combination of carotid and lower extremity ultrasonography increases the detection of atherosclerosis in type 2 diabetes patients[J].J Diabetes Complications,2012,26(1):23-28.
[24]陈鸣.彩色多普勒超声对诊断早期糖尿病肾病的价值[J].中国临床医学影像杂志,2012,23(2):88-90.
[25]Da SCA,Ribeiro JP,Canto JC,et al.High-intensity aerobic training improves endothelium-dependent vasodilation in patients with metabolic syndrome and type 2 diabetes mellitus[J].Diabetes Res Clin Pract,2012,95(2):237-245.
[26]严禹.彩色多普勒超声在诊断糖尿病下肢血管病变中的价值研究[J].中国医药科学,2005,17(9):617-619.