常规超声及二维超声剪切波弹性成像技术评价2型糖尿病周围神经病变患者股四头肌异常改变  

Evaluation of abnormal changes in the quadriceps femoris in patients with type 2 diabetes mellitus with diabetic peripheral neuropathy using conventional ultrasound and two-dimensional shear wave elastography

作　　者：邓红菊 张宇虹[1] 张萍[1] 苏本利[1] DENG Hong-ju;ZHANG Yu-hong;ZHANG Ping;SU Ben-li(The Second Hospital of Dalian Medical University,Dalian Liaoning 116023,China)

机构地区：[1]大连医科大学附属第二医院,辽宁大连116023

出　　处：《中国临床医学影像杂志》2023年第3期199-203,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:应用常规超声及二维超声剪切波弹性成像(2D-SWE)技术评价2型糖尿病(T2DM)及合并周围神经病变(DPN)患者股四头肌的异常改变。方法:收集66例T2DM患者,分为2组:合并DPN为A组(30例),不合并DPN为B组(36例);另选同期健康志愿者为对照组C组(30例)。应用常规超声测量股直肌横截面积、股直肌厚度、股外侧肌厚度、股内侧肌厚度;应用2D-SWE技术获得股直肌、股内侧肌、股外侧肌在放松体位和紧张体位下的剪切波弹性速度(SWV);同时获取受试者空腹血糖(FBG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)。结果:3组间股直肌横截面积、股直肌厚度、股外侧肌厚度、股内侧肌厚度比较,A、B组均小于C组,具有显著性差异(P均<0.05),A组小于B组,具有显著性差异(P均<0.05)。3组股直肌、股内侧肌、股外侧肌两种体位下SWV比较,A、B组均小于C组,具有显著性差异(P均<0.05),A组小于B组,具有显著性差异(P均<0.05)。结论:常规超声及2D-SWE技术能够准确、客观地评价T2DM及合并DPN患者股四头肌的异常改变,对T2DM患者下肢肌肉病变的早期预防、诊治及评估干预措施疗效具有重要临床意义。Objective:To evaluate the abnormal changes in the quadriceps femoris in patients with type 2 diabetes mellitus(T2DM)with or without diabetic peripheral neuropathy(DPN)using conventional ultrasound and two-dimensional shear wave elastography(2D-SWE).Methods:Sixty-six T2DM patients were enrolled and divided into group A(T2DM with DPN,n=30)and group B(T2DM without DPN,n=36)with healthy subjects as the control group C(n=30).The cross-sectional area of the rectus femoris,the thickness of the rectus femoris,the lateral and medial femoral muscle were measured by conventional ultrasound.The shear wave velocity(SWV)of the rectus femoris,the lateral and medial femoral muscle in relaxed and tensive positions were obtained by 2D-SWE technique.Fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)were obtained.Results:The cross-sectional area of the rectus femoris,the thickness of the rectus femoris,the lateral and medial femoral muscle in the group A and B were significantly smaller than those in the group C(all P<0.05).The cross-sectional area of the rectus femoris,the thickness of the rectus femoris,the lateral and medial femoral muscle in the group A were significantly smaller than those in the group B(all P<0.05).The SWVs of the rectus femoris,the lateral and medial femoral muscle in the group A and B were significantly smaller than those in the group C(all P<0.05).The SWVs of the rectus femoris,the lateral and medial femoral muscle in the group A were significantly smaller than those in the group B(all P<0.05).Conclusion:The abnormal changes in the quadriceps femoris of T2DM patients with or without DPN can be detected by conventional ultrasound and 2D-SWE accurately and objectively.It has important clinical significance for the early prevention,diagnosis and treatment of diabetic myopathy and evaluating the efficacy of intervention measures.

关 键 词：糖尿病 2型 周围神经系统疾病 肌疾病 超声检查 

分 类 号：R587.1[医药卫生—内分泌] R745[医药卫生—内科学] R685[医药卫生—临床医学] R445.1