2型糖尿病患者跟腱病变的超声特征  

Ultrasonographic Features of Achilles Tendinopathy in Patients with Type 2 Diabetes Mellitus

作　　者：逯雪峰 张曈[1] 杨华睿 童明辉[1] Lu Xuefeng;Zhang Tong;Yang Huarui;Tong Minghui(Department of Third Ultrasonography,Lanzhou University Second Hospital,Lianzhou 730030,China)

机构地区：[1]兰州大学第二医院超声3科,兰州市730030

出　　处：《中国超声医学杂志》2020年第2期177-180,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的利用剪切波弹性成像(SWE)评估2型糖尿病(T2DM)跟腱截面积、周长、厚径及生物学弹性的变化,并探讨T2DM患者跟腱剪切波速度与糖化血红蛋白水平之间的相关性。方法收集T2DM患者及健康体检志愿者各50例。测量跟腱中段横截面积、周长及厚径,剪切波弹性成像测量该处跟腱弹性的剪切波速度(SWV),记录T2DM患者的入院糖化血红蛋白值,绘制剪切波速度与T2DM患者糖化血红蛋白水平的相关性散点图。结果受试者左、右侧中段跟腱弹性对比及性别间对比均无统计学意义(P>0.05);对照组跟腱各参数较A组均无统计学意义(P>0.05),较B组仅SWV值有统计学意义(P<0.05),较C组跟腱周长、厚径、截面积及SWV均有显著差异,且差异有统计学意义(P<0.05);A组较B组仅SWV有统计学差异(P<0.05),A组较C组除周长无统计学意义外,其余参数均有统计学差异(P<0.05);B组较C组截面积与SWV值两参数统计学差异显著(P<0.05)。相关性分析显示,糖化血红蛋白水平与跟腱SWV值显著相关(r=0.601,P<0.05),糖化血红蛋白值越高对跟腱生物学弹性的影响也就越大。结论SWE技术可定量评估T2DM患者跟腱生物学弹性的改变,为临床医师在预防糖尿病下肢病变的过程中提供参考。Objective To evaluate the changes of tendon sectional area,circumference,thickness and biological elasticity in T2DM patients by shear wave elastography(SWE),and to explore the correlation between shear wave velocity and glycosylated hemoglobin level in T2DM patients.Methods 50 T2DM patients and 50 healthy volunteers were collected.The crosssectional area,circumference and thickness of the middle section of the Achilles tendon were measured.Shear wave elastography was used to measure the shear wave velocity(SWV)of the Achilles tendon elasticity at this point,and the hba1 cvalue of T2DM patients in hospital was recorded,so as to plot the scatter diagram of the correlation between the shear wave velocity and hba1 clevel of T2DM patients.Results There was no statistically significant difference between the left and right middle sections of the subjects(P>0.05).The Achilles tendon parameters in the control group showed no statistical significance compared with those in group A(P>0.05),only SWV values were statistically significant compared with those in group B(P<0.05),and there were significant differences in Achilles tendon circumference,thickness diameter,cross-sectional area and SWV between group C and the control group(P<0.05).Only SWV of group A was statistically different from that of group B(P<0.05),while the other parameters of group A were statistically different from that of group C(P<0.05).There were statistically significant differences between group B and group C in cross-sectional area and SWV value(P<0.05).Correlation analysis showed that glycosylated hemoglobin level was significantly correlated with Achilles tendon SWV value(r=0.601,P<0.05),and the higher the glycosylated hemoglobin value was,the greater the impact was on the biological elasticity of Achilles tendon.Conclusions SWE technique can quantitatively evaluate the changes of biological elasticity of Achilles tendon in T2DM patients,and provide a reference for clinicians in the prevention of diabetic lower extremity diseases.

关 键 词：剪切波速度 2型糖尿病 跟腱 糖化血红蛋白 

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] R686.1[医药卫生—临床医学]