高频超声结合增强型能量多普勒成像评价Ⅱ型糖尿病患者指尖微血管变化的应用研究  

High frequency ultrasonography with enhanced power Doppler imaging on detection of the fingertip's vascular changes in patients with type 2 diabetes

作　　者：王静[1] 谢明星[1] 王新房[1] 卢晓芳[1] 袁莉[1] 鲁成发[1] 吕清[1] 冷松[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科,武汉430022

出　　处：《中华超声影像学杂志》2006年第8期601-604,共4页Chinese Journal of Ultrasonography

摘　　要：目的寻找Ⅱ型糖尿病患者并发末梢微血管病变的早期证据，为临床提供有效的观察方法和指标。方法应用高频超声结合增强型能量多普勒显像（e-Flow）观察30例Ⅱ型糖尿病患者右手中指末节指腹和甲床内微血管床的分布特征、走行和数量，并计算指腹动脉和甲床动脉的收缩期峰值速度（PSV）、舒张期峰值速度（EDV）以及血管阻力（RI）参数。观察结果与32例年龄、性别相匹配的健康成人对照。结果①正常人中指末节指腹的血管供应丰富，e-Flow清晰显示手指的两支掌侧固有动脉及发出的分支，呈网状分布于整个指腹。血管形态勾勒清晰，走行正常，可追踪全程；甲床内微血管呈纵行分布，末梢可见横行吻合支，血管网清晰，血供丰富。②糖尿病患者中指的末节指腹血管网显示欠丰富，仅可显示一或两支固有动脉分支或仅见零星点条状血流，血管走行迂曲断续，与正常人差异有统计学意义（P〈0．05）；甲床内微血管，尤其是远端血管显示不良，仅见零星点条状血流，与正常人差异有统计学意义（P〈0．05）；糖尿病合并症者的指端微血管异常较单纯糖尿病患者为甚。③与正常人比较，糖尿病患者的指腹动脉、甲床动脉PSV、EDV测值稍减低（P〈0．05～0．09），RI相应升高（P〈0．05）。结论E-Flow结合传统彩色多普勒血流成像技术可敏感、准确地反映糖尿病患者的指端微血管分布减少，血管阻力增高，为临床早期诊断糖尿病微血管病变和评价治疗效果提供了新手段。Objective To probe into the clinical value of enhanced power Doppler imoging（e-Flow） on the early detection of fingertip＇s vessel morphological and flow dynamic changes in patients with type 2 diabetes mellitus （DM2）. Methods Thirty patients with DM2 and 32 age-matched healthy subjects were observed by twodimensional and pulsed wave e-Flow imaging. The right middle fingertip＇s blood supply, vessel configuration, distribution and the blood flow peak systolic velocity（PSV）, end-diastolic velocity（EDV）, vascular resistance index （RI） of finger ventral arteriole and nail bed arteriole were separately assessed. Results ①Blood supply inside the fingertip was very rich in most of normal subjects. The e-Flow could outline the branches of finger ventral arteriole arch and finger dorsal arteriole arch, made up of palmar digital arteries of finger reticulated the whole finger ventral. The lengthways arterioles in finger back inosculated at the cross of one third up middle and down middle of the nail bed each other. ②Blood supply inside the fingertip was little or scares in patients with DM2. The e-Flow could only display one or two branches. The vessel was circuitous intermittent（ P 〈0.05）. The vessels of nail bed,especially for the distal vessels, could not be outlined. There was significant differences between DM group and normal subjects （ P 〈0.05）. The abnormal changes in fingertip and nail bed were slighter serious in DM2 patients with hypertension or （and） hyperlipemia.③Compared with those of normal subjects, the PSV and EDV in finger ventral arteriole and nail bed arteriole of DM2 were slightly decreased（ P 〈0.05 - 0.09）, RI still increased（ P 〈 0.05）. Conclusions E-Flow is reliable to represent the blood perfusion in the vessels. The fingertips blood vessel capacity declined and the RI increased in patients with DM2.

关 键 词：超声检查 糖尿病 Ⅱ型 指 小动脉 

分 类 号：R445.1[医药卫生—影像医学与核医学]