超声在评价2型糖尿病血瘀证早期动脉功能减退中的价值  

Evaluation of arterial function of blood-stasis syndrome of type 2 diabetic mellitus in the earlier period by ultrasonography

作　　者：任亚娟[1] 肖沪生[1] 银浩强[1] 徐芳[1] 彭欣[1] 陆盈[1] 潘明 

机构地区：[1]上海中医药大学附属龙华医院超声科,上海200032 [2]上海市枫林街道社区卫生服务中心,上海200032

出　　处：《中国中西医结合影像学杂志》2012年第1期41-44,50,I0003,共6页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：上海市教育委员会科研基金项目(编号:2008CZ020)

摘　　要：目的:通过应用超声多种检测技术,全面评估2型糖尿病(T2DM)血瘀证患者的动脉功能状态,初步探讨T2DM血瘀证患者早期动脉功能改变的特点及超声在糖尿病血瘀证早期动脉病变检测中的应用价值。方法:选择颈动脉内-中膜无增厚、无斑块的T2DM血瘀证患者30例,非血瘀证患者30例。应用血管回声跟踪技术(ET)、动脉硬化检测技术(PWV/ABI)及血流介导的内皮依赖性血管舒张功能检测(FMD)等技术,检测入选病例的各项指标,分析糖尿病血瘀证与非血瘀证患者动脉功能改变的特点及超声在评价T2DM血瘀证早期动脉功能减退中的价值。结果:①血瘀证组与非血瘀证组的年龄、性别比差异无统计学意义(P>0.05),血瘀证组的病程长于非血瘀证组,差异有统计学意义(P<0.01)。②血瘀证组的肱动脉内径变化绝对值、内径扩张百分率均较非血瘀证组减小,差异有统计学意义(P<0.05)。③血瘀证组的应变弹性指数(EP)、硬化参数(β)、脉搏波传导速度(PWVβ)值大于非血瘀证组,差异有统计学意义(P<0.05),顺应性(AC)值小于非血瘀证组,差异有统计学意义(P<0.05),2组的增大指数(AI)值差异无统计学意义(P>0.05)。④血瘀证组的肱踝脉搏波传导速度(baPWV)值大于非血瘀证组,差异有统计学意义(P<0.05),2组的踝臂血压指数(ABI)值无明显差异(P>0.05)。结论:①T2DM血瘀证组的病程明显长于非血瘀证组,提示糖尿病病程越长越容易发生血瘀证。②T2DM血瘀证患者血管内皮功能及弹性功能均有损害,血管功能低于非血瘀证患者,提示血瘀证患者更易发生血管病变。③超声可用于评价T2DM不同中医证型患者的动脉功能状态,可以为T2DM的中医分型治疗提供客观依据。Objective： To evaluate the arterial function of blood-stasis syndrome of type 2 diabetic mellitus comprehensively by a plenty of methods of ultrasonography and analyze the value of ultrasonography in evaluating and detecting the arterial function of blood-stasis syndrome of type 2 diabetic mellitus in the earlier period. Methods： Type 2 diabetes mellitus patients without plaque and thick carotid intima-media thickness （IMT） were classified into two groups by syndrome differentiation： blood stasis group and non-blood stasis group, 30 in each group, eTRACKING,PWV/ABI and FMD detection technique were all applied in evaluating their arterial function. By this way the value of ultrasonography in evaluating and detecting the arterial function of blood-stasis syndrome of type 2 diabetic mellitus and the feature of the arterial change of type 2 diabetic mellitus in the earlier period were analyzed. Results：①When the blood stasis group was compared with the non-blood stasis group,their age and sex ratio were respectively with no statistical significance （P〉0.05）. The course of disease of blood stasis group was significantly longer than that of non-blood stasis group （P〈0.01）. ②The change and the dilative percentage of brachial arterial diameter af- ter reactive hyperemia of blood stasis group were statistically lower than those of non-blood stasis group （P〈0.05）. ③When the blood stasis group was compared with the non-blood stasis group,Ep and i3 were statistically bigger （P〈0.05） ,AC is sta- tistically smaller （P〈0.05） and AI was respectively with no statistical significance（P〉0.05）. ④When the blood stasis group was compared with the non-blood stasis group, baPWV was statistically bigger （P〈O. 05） and ABI was respectively with no statistical significance（P〉0.05）. Conclusions：① The course of disease of blood stasis group was significantly longer than that of non-blood stasis group that indicated that blood-stasis syndrome always occurred in the patient

关 键 词：超声检查 多普勒 彩色 糖尿病 2型 血瘀 

分 类 号：R259[医药卫生—中西医结合]