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目的探讨应用二维斑点追踪技术(2D-STI)评价2型糖尿病(T2DM)患者股总动脉弹性变化及其与周围血管病(PVD)症状的相关性。方法应用常规超声及2D-STI技术测量并记录T2DM患者股总动脉收缩期内径(Dd)、舒张期内径(Ds)、血管壁运动度(ΔD)、阻力指数(RI)及股动脉的内中膜(IMT)厚度、僵硬度参数(β)、整体及六个节段的圆周应变(CS)、圆周应变率(CSR)。结果病例组均较正常对照组整体CS、CSR及11~1点、7~9点CS、CSR明显降低(P<0.01),ΔD减低(P<0.05),β与IMT均增加(P<0.05),RI增加(P>0.05);PVD组较无PVD组整体CS、CSR及11~1点、5~7点、7~9点CS、CSR降低(P<0.05),β增加(P<0.05),ΔD、RI及IMT无明显差异(P>0.05)。PVD症状与整体CS、CSR呈负相关、与β呈正相关(P<0.05)。结论应用2D-STI技术能评价T2DM患者下肢动脉的弹性变化,为其PVD症状的早期诊断和治疗提供临床依据。
Objective To investigate the relationship between the changes of femoral common artery elasticity and peripheral vascular disease (PVD) in patients with type 2 diabetes mellitus (T2DM) by 2D-STI. Methods Conventional ultrasound and 2D-STI technique were used to measure and record the systolic diameter (Dd), diastolic diameter (Ds), vascular wall motion (ΔD), resistance index (RI) and femoral artery in T2DM patients (IMT) thickness, stiffness parameter (β), global and six-segment circumferential strain (CS), and circumferential strain rate (CSR). Results Compared with the control group, the CS, CSR and CS, CSR and CS, CSR at 7-9 were significantly lower (P <0.01), the ΔD was lower (P <0.05) (P <0.05), and increased RI (P> 0.05). Compared with non-PVD group, the changes of CSR and CSR in the PVD group were significantly lower than those in the non-PVD group at 11 and 1, 5 and 7, 7 and 9, 0.05), there was no significant difference in ΔD, RI and IMT (P> 0.05). The symptoms of PVD were negatively correlated with overall CS and CSR, and positively correlated with β (P <0.05). Conclusion The 2D-STI technique can be used to evaluate the elasticity of the lower extremity arteries in T2DM patients and provide a clinical basis for the early diagnosis and treatment of PVD symptoms.