彩色多普勒超声在诊断糖尿病患者下肢动脉粥样硬化的临床应用价值  

Clinical application values of color doppler ultrasound in the diagnosis of lower extremity atherosclerosis in patients with diabetes

作　　者：黄燕媚[1] 张志尚[2] 王蕾[3] HUANG Yan-mei;ZHANG Zhi-shang;WANG Lei(Department of Special Clinic,Chinese People＇s Liberation Army 188th Hospital,Chaozhou 521000,China)

机构地区：[1]中国人民解放军第188医院特诊科,521000 [2]中国人民解放军第188医院病理科,521000 [3]中国人民解放军第421医院特检科,510000

出　　处：《中国实用医药》2018年第28期8-10,共3页China Practical Medicine

摘　　要：目的研究分析在诊断糖尿病患者下肢动脉粥样硬化中采用彩色多普勒超声的应用价值。方法选取80例2型糖尿病患者作为观察组,另选同期80例健康体检者作为对照组,比较两组彩超检查结果和各血管内膜中层厚度(IMT)水平,并分析糖尿病患者下肢动脉病变分布及下肢动脉彩色多普勒超声图像特征。结果观察组管腔内膜光滑率低于对照组,不光滑有斑块率显著高于对照组,差异具有统计学意义(P<0.05)。观察组腘动脉、股动脉、胫前动脉、胫后动脉、足背动脉各动脉的IMT水平均显著高于对照组,差异具有统计学意义(P<0.05)。超声检查显示,糖尿病患者管腔存在斑块共60例,其中14例同时分布于2个或以上的下肢动脉中。主要分布:腘动脉17例(28.33%)、股动脉11例(18.33%)、胫前动脉16例(26.67%)、胫后动脉17例(28.33%)及足背动脉20例(33.33%)。有斑块且出现狭窄或闭塞情况以足背动脉最为常见,有13例(21.67%);胫后动脉次之,有7例(11.67%);然后分别为胫前动脉6例(10.00%)、腘动脉6例(10.00%)、股动脉1例(1.67%)。对于下肢动脉IMT增加且有斑块存在的糖尿病患者, IMT>1 mm,血管壁表现较为毛糙,血流束边缘呈不规则形态,且充盈存在缺损;对于下肢动脉硬化斑块导致血管腔狭窄或闭塞的患者,血管腔内部血流束直径减小,无血流信号,表现为单峰或双相波形的频谱特征。结论诊断糖尿病患者下肢动脉粥样硬化采用彩色多普勒超声能够有效诊断出下肢动脉血管病变,明确血管病变位置、严重程度,值得推广。Objective To study and analyze the application values of color doppler ultrasound in the diagnosis of lower extremity atherosclerosis in patients with diabetes. Methods A total of 80 patients with type 2 diabetes were selected as the observation group, another 80 healthy physical examination persons in the same period were selected as control group. The results of color doppler ultrasound and the levels of intima media thickness（IMT） in each artery between the two groups were compared, and the distribution of lower extremity arterial disease and color doppler ultrasound imaging characteristics of lower extremity artery in diabetes patients were analyzed. Results The smooth rate of lumen intima in the observation group was significantly lower than that in the control group, and the rate of plaque with no smooth surface in the observation group was significantlyhigher than that in the control group, the differences were statistically significant（P0.05）. The IMT of each artery（popliteal artery, femoral artery, anterior tibial artery, posterior tibial artery and dorsalis pedis artery） in the observation group were significantly higher than those in the control group, the differences were statistically significant（P0.05）. The ultrasound examination showed that there were 60 cases of plaque in the lumen of patients with diabetes, among them, 14 cases were distributed in 2 or more lower extremity arteries. And they were mainly distributed in the 17 cases（28.33%） of popliteal artery, 11 cases（18.33%） femoral artery, 16 cases（26.67%） of anterior tibial artery, 17 cases（28.33%） of posterior tibial artery and 20 cases（33.33%） of dorsalis pedis artery. Arteria dorsalis pedis artery was the most common plaque with stenosis or occlusion, there were 13 cases（21.67%）, 7 cases（11.67%） of posterior tibial artery, 6 cases（10.00%） of anterior tibial artery, 6 cases（10.00%） of popliteal artery and 1 case（1.67%） of femoral artery. For diabetes patients with increased IMT and plaq

关 键 词：糖尿病 下肢动脉粥样硬化 彩色多普勒超声 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R587.2[医药卫生—诊断学]