超声弹性成像技术在测量2型糖尿病合并高血压患者颈、肱动脉血管壁弹性中的价值分析
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摘要
目的:分析超声弹性成像技术测量2型糖尿病(T2DM)合并高血压患者颈、肱动脉血管壁的应变率比值(B/A)及其与脉压、血糖和颈、肱动脉内膜中层厚度(IMT)的相关性。方法:采用数表法随机选取108例T2DM患者,按病情将其分为T2DM+高血压组和T2DM组,每组54例;同期选取40名健康体检者纳入健康对照组。通过超声弹性成像技术测量3组的颈、肱动脉弹性功能参数,并分析3组的颈、肱动脉B/A值及其与脉压、血糖和IMT的相关性。结果:T2DM+高血压组和T2DM组的颈、肱动脉B/A值较健康对照组显著升高,差异有统计学意义(F=13.97,P<0.05),且T2DM+高血压组的颈、肱动脉B/A较T2DM组显著升高,其差异有统计学意义(F=17.90,P<0.05);T2DM+高血压组和T2DM组的IMT较健康对照组显著升高,其差异有统计学意义(F=10.07,P<0.05)。颈动脉IMT与脉压和血糖均存在明显正相关关系(r=0.58,r=0.55;P<0.01);颈动脉B/A值与IMT和脉压均存在正相关关系(r=0.42,r=0.45;P<0.01);肱动脉B/A值与血糖存在正相关关系(r=0.36,P<0.01)。结论:通过超声弹性成像技术,T2DM合并高血压患者可准确有效地了解早期的动脉血管壁弹性变化。
Objective: To analyze the strain rate ratio(B/A) of vascular wall of carotid and brachial arteries of patients with type 2 diabetes mellitus(T2DM) with hypertension that was measured by ultrasound elastography, and the correlations between it and pulse pressure, blood glucose and intima-media thickness(IMT) of carotid and brachial artery, respectively. Methods: 108 patients with T2DM were selected by random number table. And they were divided into "T2DM + hypertension" group and "T2DM" group(54 cases in each group) according to their condition. At the same time, 40 healthy persons in physical examination were enrolled in the healthy control group. The elastic function parameters of carotid and brachial arteries of 3 groups were measured by ultrasound elastography, and B/A value of carotid and brachial arteries of 3 groups and the correlations between B/A value and pulse pressure, blood glucose and IMT were further analyzed. Results: The B/A values of the carotid and brachial arteries in "T2DM + hypertension" group and "T2DM" group were significantly higher than those in healthy control group(F=13.97, P<0.05), respectively, and the B/A value of the carotid and brachial arteries in "T2DM + hypertension" group were significantly higher than that in "T2DM" group(F=17.90, P<0.05). And the IMTs in "T2DM + hypertension" group and "T2DM" group was significantly higher than that in healthy control group(F=10.07, P<0.05). IMT of carotid artery was positive correlation with pulse pressure and blood glucose(r=0.58, r=0.55, P<0.01), respectively. And the B/A value of carotid artery was positive correlation with IMT and pulse pressure(r=0.42, r=0.45, P<0.01), respectively. And B/A value of brachial artery was positive correlation with blood glucose(r=0.36, P<0.01). Conclusion: Patients with T2DM with hypertension can accurately and effectively find early elastic changes of vascular wall of artery through ultrasound elastography.
Objective: To analyze the strain rate ratio(B/A) of vascular wall of carotid and brachial arteries of patients with type 2 diabetes mellitus(T2DM) with hypertension that was measured by ultrasound elastography, and the correlations between it and pulse pressure, blood glucose and intima-media thickness(IMT) of carotid and brachial artery, respectively. Methods: 108 patients with T2DM were selected by random number table. And they were divided into "T2DM + hypertension" group and "T2DM" group(54 cases in each group) according to their condition. At the same time, 40 healthy persons in physical examination were enrolled in the healthy control group. The elastic function parameters of carotid and brachial arteries of 3 groups were measured by ultrasound elastography, and B/A value of carotid and brachial arteries of 3 groups and the correlations between B/A value and pulse pressure, blood glucose and IMT were further analyzed. Results: The B/A values of the carotid and brachial arteries in "T2DM + hypertension" group and "T2DM" group were significantly higher than those in healthy control group(F=13.97, P<0.05), respectively, and the B/A value of the carotid and brachial arteries in "T2DM + hypertension" group were significantly higher than that in "T2DM" group(F=17.90, P<0.05). And the IMTs in "T2DM + hypertension" group and "T2DM" group was significantly higher than that in healthy control group(F=10.07, P<0.05). IMT of carotid artery was positive correlation with pulse pressure and blood glucose(r=0.58, r=0.55, P<0.01), respectively. And the B/A value of carotid artery was positive correlation with IMT and pulse pressure(r=0.42, r=0.45, P<0.01), respectively. And B/A value of brachial artery was positive correlation with blood glucose(r=0.36, P<0.01). Conclusion: Patients with T2DM with hypertension can accurately and effectively find early elastic changes of vascular wall of artery through ultrasound elastography.
引文
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[13]Domenichini R,Pialat JB,Podda A,et al.Ultrasound elastography in tendon pathology:state of the art[J].Skeletal Radiol,2017,46(12):1643-1655.
[14]Saed L,Deihim Z,Naghshbandi MK,et al.Cardiovascular events in patients with over 10years history of type 2 diabetes mellitus[J].Diabetes Metab Syndr,2019,13(1):68-72.
[15]Kim MK,Han K,Koh ES,et al.Blood pressure and development of cardiovascular disease in Koreans with type 2 diabetes mellitus[J].Hyper tension,2019,73(2):319-326.
[16]Lastra G,Syed S,Kurukulasuriya LR,et al.Type 2 diabetes mellitus and hypertension:an update[J].Endocrinol Metab Clin North Am,2014,43(1):103-122.
[2]Van Vugt HA,Boels AM,de Weerdt I,et al.Patient activation in individuals with type 2diabetes mellitus:associated factors and the role of insulin[J].Patient Prefer Adherence,2018,13(1):73-81.
[3]朱燕.超声弹性成像在诊断前列腺恶性肿瘤中的应用与研究进展[J].临床超声医学杂志,2016,18(7):477-479.
[4]王立娟,李春梅,秋阳,等.萤火虫成像技术和弹性成像技术联合应用诊断甲状腺结节[J].中国医药,2013,8(3):398-400.
[5]施燕芸,戚庭月.超声弹性成像在甲状腺结节中的应用进展[J].医学综述,2017,23(10):2035-2040.
[6]杨蕾,张彦,梁会泽,等.乳腺影像学报告及数据系统与超声造影和弹性成像联合应用鉴别乳腺病灶良恶性的价值[J].中国医药,2015,10(2):233-235.
[7]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):4-67.
[8]中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华心血管病杂志,2011,39(7):579-616.
[9]Mancia G,Cannon CP,Tikkanen I,et al.Impact of empagliflozin on blood pressure in patients with type 2 diabetes mellitus and hypertension by background antihypertensive medication[J].Hypertension,2016,68(6):1355-1364.
[10]Liang H,Wang D,Che G,et al.Evaluation of carotid artery elasticity in patients with uremia by echo tracking[J].J Med Ultras on(2001),2018,45(4):591-596.
[11]Li Y,Deng YB,Bi XJ,et al.Evaluation of myocardial strain and artery elasticity using speckle tracking echocardiography and highresolution ultrasound in patients with bicuspid aortic valve[J].Int J Cardiovasc Imaging,2016,32(7):1063-1069.
[12]Sigrist RMS,Liau J,Kaffas AE,et al.Ultrasound elastography:Review of techniques and clinical applications[J].Theranostics,2017,7(5):1303-1329.
[13]Domenichini R,Pialat JB,Podda A,et al.Ultrasound elastography in tendon pathology:state of the art[J].Skeletal Radiol,2017,46(12):1643-1655.
[14]Saed L,Deihim Z,Naghshbandi MK,et al.Cardiovascular events in patients with over 10years history of type 2 diabetes mellitus[J].Diabetes Metab Syndr,2019,13(1):68-72.
[15]Kim MK,Han K,Koh ES,et al.Blood pressure and development of cardiovascular disease in Koreans with type 2 diabetes mellitus[J].Hyper tension,2019,73(2):319-326.
[16]Lastra G,Syed S,Kurukulasuriya LR,et al.Type 2 diabetes mellitus and hypertension:an update[J].Endocrinol Metab Clin North Am,2014,43(1):103-122.