彩色多普勒技术测定动脉踝肱指数在2型糖尿病外周血管病变中的应用

The Application of ABI in Peripheralvascular Disease Using the Method of CDFI in Type 2 Diabetic

摘要: 目的：采用彩色多普勒血流成像技术测定2型糖尿病患者的踝肱指数，研究踝肱指数与糖尿病合并血管病变的关系，为临床T2DM患者血管病变的早期诊断提供依据。方法：选择健康志愿者40例(A组)及包头医学院第一附属医院住院的65例2型糖尿病患者，均按WHO诊断标准及临床特点确诊，采用飞利浦IU22彩色超声诊断仪测定踝肱指数，以踝肱指数 < 0.9为外周血管病变组(B组)，踝肱指数 ≥ 0.9为非外周血管病变组(C组)，应用单因素方差分析比较两组病人的年龄、性别、病程、血脂及糖化血红蛋白等各项检验指标及踝肱指数，以P < 0.05认为差异有统计学意义。结果：65例2型糖尿病患者中B组21例，其中出现足部的坏疽及溃疡的1例，出现足背动脉搏动减弱、间歇性跛行或静息痛6例，下肢动脉的硬化狭窄17例；C组44例，其中足背动脉搏动减弱、间歇性跛行或静息痛有3例，无一例发生足部的坏疽及溃疡，无下肢动脉的硬化狭窄，两组间差异有统计学意义(P < 0.05)。结论：2型糖尿病患者中踝肱指数降低程度与外周血管病变发生率呈正相关，两组组临床资料比较，前者具有年龄大、病程长、血脂、糖化血红蛋白明显升高的特点。彩色多普勒血流成像技术检测2型糖尿病患者踝肱指数，可用于判断2型糖尿病患者外周血管病变程度，为临床预防其的发生发展提供可靠依据。 Purpose: Research the relationship between ABI (ankle brachial index) and diabetes mellitus with vascular disease using color Doppler ultrasound in diabetic patients, providing the early information of diabetic vascular disease to the clinicians. Objects and Methods: Choose 44 healthy volunteers (group A) and 65 patients in our hospital diagnosed as type 2 diabetes with WHO diagnostic criteria and clinical characteristics and collected the various clinical data. Then, measured ABI using the method of CDFI With Philips IU22 color ultrasound diagnostic apparatus, ABI equal 0.9 as the Separatrix, the PAD group (group B) with ABI less than 0.9 and greater than 0.9 belongs to the non-PAD group (group C). Single factor analysis of variance compared the two groups of patients in ABI and age, gender, disease duration, FPG, HbA1c, TG, CHOL, HDL-C, LDL-C, EDD, with P < 0.05 considered statistically significant. Results: 65 patients with T2DM patients with ABI less than0.9 in21 cases, there’s gangrene and ulcer in foot 1 case, there dorsalis pedis artery fluctuations reduced, intermittent claudication or pain at rest in 6 patients (33%), while the group B in 3 patients (4%) dorsalis pedis artery pulse weakened, intermittent claudication or pain at rest, two groups there were significant differences (P < 0.05). The more significantly the ABI value reduced, the more significantly different in age, duration, TG, LDL-C, HbA1cbetween the two group (P < 0.05). Conclusion: The application of ABI in peripheralvascular disease using the method of CDFI in type 2 diabetes mellitus can be used to test the seriousness of vascular complications.