超声造影在评价糖尿病足溃疡患者肢端微循环损害中的应用价值  

Application Value of Contrast-enhanced Ultrasound in Evaluation of ExtremitiesMicrocirculation Damage in Patients with Diabetes Foot Ulc

作　　者：韩志芬 康彧[2] 王渠[2] 沙晓溪[2] 方雪 胡敏[2] Han Zhifen;Kang Yu;Wang Qu;Sha Xiaoxi;Fang Xue;Hu Min(School of Medical and Life Sciences,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China;Department of Ultrasound Medicine,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China)

机构地区：[1]成都中医药大学医学与生命科学学院,成都市611137 [2]成都中医药大学附属医院超声医学科,成都市610072

出　　处：《中国超声医学杂志》2023年第5期573-576,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家中医药管理局基金项目(No.JDZX2015218);成都中医药大学附属医院科研项目(No.21MZ02)。

摘　　要：目的 探讨超声造影(CEUS)在2型糖尿病足溃疡(DFU)患者足部微循环评价中的应用价值。方法 纳入2型DFU患者86例,根据是否合并外周动脉病变(PAD)分为单纯DFU组(47例)和DFU合并PAD(DFU-PAD)组(39例),另选取非糖尿病且不伴有PAD 20例为对照组。所有研究对象行足踝部CEUS,运用定量技术评价足踝部软组织微循环灌注,获取时间-强度曲线(TIC),分析峰值强度(PI)、曲线下面积(AUC)、平均通道时间(MTT)以及软组织-足背动脉达峰时间差(T-A TTP),比较3组之间的灌注差异。结果 PI、AUC值在对照组、单纯DFU组和DFU-PAD组表现为依次减低,差异有统计学意义(P<0.05);T-A TTP在对照组、单纯DFU组和DFU-PAD组表现为依次延长,差异有统计学意义(P<0.05);MTT在3组间差异无统计学意义(P>0.05)。结论 CEUS及其定量分析技术可以反映DFU患者足部微循环受损程度,对临床全面评估DFU合并PAD肢端血流灌注具有一定应用价值。Objective To evaluate the value of contrast-enhanced ultrasound(CEUS)in the evaluation of foot microcirculation in patients with type 2diabetic foot ulcer.Methods A total of 86patients with type 2diabetic foot ulcer(DFU)were enrolled and divided into simple DFU group(n=47),and DFU with PAD(DFU-PAD)group(n=39)according to whether they were complicated with peripheral artery disease(PAD)or not.A total of 20patients without DFU and PAD were enrolled as the control group.CEUS of foot and ankle was performed in all patients.Quantitative technique was used to evaluate the perfusion of the dorsal pedal artery and soft tissue between the dorsal pedal artery and anterior capsule of ankle joint.The perfusion characteristics of CEUS and parameters of time-intensity curves(TIC)were analyzed.Results Peak intensity(PI)and area under the curve(AUC)decreased in the control group,the simple DFU group and the DFU-PAD group(P<0.05)in succession,while T-A TTP(tissue-artery time to peak)was prolonged gradually in the control group,the simple DFU group and the DFU-PAD group(P<0.05),but there was no significant difference in mean transit time(MTT)among the three groups(P>0.05).Conclusions CEUS and its quantitative analysis techniques can reflect the degree of foot microcirculation damage in patients with DFU,and may be helpful for the overall evaluation of limb blood perfusion in patients with DFU complicated with PAD.

关 键 词：超声造影 糖尿病足溃疡 外周动脉病变 微循环 

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]