血管回声跟踪技术对2型糖尿病患者颈总动脉弹性的评价

摘要

目的 应用血管回声跟踪技术(echo-tracking,ET),观察2型糖尿病(T2DM)患者颈总动脉弹性变化情况,为其周围血管病变的早期诊断和治疗提供依据.方法 选择糖尿病患者60例,其中内-中膜正常组20例(A组)、内-中膜增厚组20例(B组)和单发斑块组20例(C组),另选正常对照组20例.将取样容积分别置于双侧颈总动脉距窦部近心端2 cm处,常规测量内中膜厚度(IMT).采用ET技术自动跟踪颈总动脉的运动,检测以下参数:压力应变弹性系数(Ep)、僵硬系数(β)、顺应性(AC)和脉搏波传导速度(PWVβ),并分析这些指标在糖尿病各组之间及糖尿病组与正常对照组间的差异性.结果 糖尿病组IMT、Ep、β及PWVβ均明显高于对照组,差异有高度统计学意义(P < 0.01),B、C组的Ep、β及PWVβ又高于A组,差异有高度统计学意义(P < 0.01).A、B、C三组AC值明显低于对照组,B、C组又低于A组,差异有统计学意义(P < 0.05或P < 0.01).B、C两组间Ep、β、PWVβ、AC值比较差异无统计学意义(P > 0.05).结论 ET技术可早期反映糖尿病患者颈总动脉弹性改变,并能在IMT增厚之前对患者颈总动脉硬化做出预测,有利于血管病变的早期诊断与治疗.%Objective To observe the common carotid artery elastic changes in patients with type 2 diabetes (T2DM) by using echo-tracking (ET) for providing the basis in the early diagnosis and treatment of peripheral vascular lesions. Methods 60 patients with type 2 diabetes mellitus and 20 control subjects were enrolled. The patients were divided into three groups: group A of normal intima, group B of thickened intima and group C of single plaque of common carotid artery. The sample volume was placed in 2 cm below the bilateral common carotid artery bifurcation and intima-media thickness (IMT) was measured. ET automatic was used to track the motion of carotid artery, and the following parameters: pressure-strain elasticity modulus (Ep), stiffness parameter (P), arterial compliance (AC) and one-point pulse wave velocity (PWVP) were measured. And the difference of the indicators above between the diabetic group and control group was analyzed. Results IMT, Ep, PWVP and P in diabetic group were obviously higher than those of control group (P < 0.01), Ep, PWVP and P in group B, C were higher than those of group A, and the difference was significant (P < 0.01). AC value in A, B, C group were significantly lower than those in the control group, AC value in group B, C were lower than those in group A, the difference was significant (P < 0.05 or P < 0.01). There were no differences in Ep, PWVP, P and AC between group B, C and there was no difference in AI among these groups (P > 0.05). Conclusion ET can reflect the elastic changes in patients with type 2 diabetes mellitus earlier for diagnosing the vascular lesions before thickened IMT of common carotid artery ap -peared.