2型糖尿病患者周围动脉弹性改变特点及相关影响因素分析  

Characteristics and Related Factors of Peripheral Arterial Elasticity Change in Patients with Type 2 Diabetes Mellitus

作　　者：郑金珏[1] 李秀云[1] 周琳 陈倩倩[1] 郑超[2] 邹春鹏[1] Zheng Jinjue;Li Xiuyun;Zhou Lin(Department of Ultrasound,Second Affiliated Hospital of Wenzhou Medical College,Zhejiang 325000,China)

机构地区：[1]温州医科大学附属第二医院超声科,325027 [2]温州医科大学附属第二医院内分泌科,325027

出　　处：《医学研究杂志》2019年第11期127-131,共5页Journal of Medical Research

基　　金：浙江省温州市科技局计划项目(Y20160495,Y20160487,Y20170296)

摘　　要：目的本研究旨在应用应变及应变率成像技术探讨2型糖尿病患者周围动脉弹性改变特点及相关影响因素.方法选取有血管并发症的2型糖尿病患者40例(T2DMVC组),无血管并发症的2型糖尿病患者42例(T2DM组),健康对照组60例.用高频线阵探头测量双侧颈总动脉、肱动脉、股动脉和胫前动脉的IMT值,用Xstrain自动分析软件获取各动脉壁各节段最大圆周应变平均值(Smax)和应变率的平均值(SRmax),进一步计算各动脉应变及应变率比值.结果与对照组比较,T2DM及T2DMVC组双侧颈动脉及股动脉的IMT值均增高,应变和应变率均明显下降(P均<0.05).与T2DM组比较,T2DMVC组双侧胫前动脉应变及应变率明显减低(P<0.05).多元线性回归分析表明,影响颈动脉和肱动脉与下肢动脉间Smax及SRmax比值的独立风险因素包括病程、甘油三酯、低密度脂蛋白胆固醇;影响颈动脉与肱动脉、股动脉与胫前动脉间Smax及SRmax比值的独立风险因素包括病程、糖化血红蛋白及甘油三酯.结论应变及应变率成像技术不仅可以反映2型糖尿病患者单支周围动脉的应变情况,还可通过不同周围动脉间的应变比值反映其相对变化.Objective To investigate the changes and correlated factors of peripheral arterial elasticity in patients with type 2 diabetes mellitus with strain and strain rate imaging.Methods Forty patients with type 2 diabetes mellitus combed with vascular complication(group T2DMVC),42 patients with type 2 diabetes without vascular complications(group T2DM)and 60 healthy volunteers(control group)were included in this study.We measured bilateral brachial artery and foot arterial blood pressure,calculated ankle-brachial index(ABI).IMT of bilateral common carotid artery,brachialartery,femoral artery and tibial artery were measured by using high-frequency linear array probe.The average of maximum circumferential strain(Smax)and strain rate(SRmax)of each segment of wall of arteriall were measured by using X-strain automatic analysis software.Strain and strain rate ratio between arteries were calculated furtherly.Results Compared with the control group,the IMT of the bilateral carotid artery and femoral artery in group T2DM and T2DMVC were both significantly increased,and the strain and strain rate were both significantly decreased(both P<0.05).Compared to T2DM group,the strain and strain rate of bilateral anterior tibial artery in group T2DM+AR were significantly reduced(P<0.05).Multiple linear re?gression analysis showed that independent risk factors which affected Smax and SRmax ratio between carotid artery,brachial artery and lower limb arteries include course of disease,triglyceride and low density lipoprotein cholesterol.Factors that affected the Smax and SRmax ratio between carotid artery and brachial artery,Smax and SRmax ratio between carotid artery and brachial artery included the course of disease,triglyceride,and glycosylated hemoglobin.Conclusion Strain and strain rate imaging can reflect the strain and strain rate of the wall of peripheral artery,and the relative changes can be reflected by the strain and strain rate ration between different arteries.

关 键 词：应变和应变率成像 周围动脉 2型糖尿病 血管并发症 弹性 

分 类 号：R4[医药卫生—临床医学]