彩色多普勒超声与踝臂指数在糖尿病足患者下肢动脉病变诊断中的应用  

Color Doppler Ultrasound and Ankle-Arm Index in the Diagnosis of Lower Extremity Arteriopathy in Patients with Diabetic Foot

作　　者：杨继正 田禧禧 杜梅 张红[1] YANG Jizheng;TIAN Xixi;DU Mei;ZHANG Hong(Department of Ultrasound,Nanyang Oilfield General Hospital,Nanyang Henan 473132,China)

机构地区：[1]南阳油田总医院超声科,河南南阳473132

出　　处：《临床研究》2023年第9期129-132,共4页Clinical Research

摘　　要：目的分析彩色多普勒超声(CDFI)与踝臂指数(ABI)在糖尿病足(DF)患者下肢动脉病变中的诊断效能。方法将2021年1月至12月就诊于南阳油田总医院的100例DF患者作为DF组,另选同期50例健康体检者作为对照组。所有受检者均接受CDFI、ABI检查,比较两组不同部位CDFI参数(动脉内径、内膜-中层膜厚度、阻力指数)、CDFI阳性率、ABI阳性率,将数字减影血管造影结果作为金标准,评估CDFI、ABI及二者联合对DF患者伴下肢动脉病变的诊断效能。结果DF组胫后动脉、胫前动脉、足背动脉内径显著低于对照组;DF组股深动脉、胫后动脉、股浅动脉、腘动脉、胫前动脉与足背动脉的内膜-中层膜厚度、阻力指数显著高于对照组;数字减影血管造影结果显示,DF组100例患者中出现下肢动脉病变85例(85.00%),其中闭塞34例,斑块41例,狭窄10例;DF组内-中膜增厚、斑块、闭塞检出率显著高于对照组;DF组ABI<0.9阳性率显著高于对照组,0.9-1.3阳性率显著低于对照组;CDFI与ABI联合诊断DF患者伴下肢动脉病变的敏感度、阴性预测值与准确度均高于单一诊断,差异有统计学意义(P<0.05)。结论CDFI可反映管腔内膜增厚程度、动脉管腔大小、管腔内血流动力学改变,与ABI联合检查可提升DF患者下肢动脉病变的诊断效能。Objective To evaluate the efficacy of color Doppler ultrasound(CDFI)and ankle-arm index(ABI)in the diagnosis of lower extremity arteriopathy in patients with diabetic foot(DF).Methods A total of 100 DF patients who were admitted to Nanyang Oilfield General Hospital from January to December 2021 were selected as the DF group,and 50 healthy subjects in the same period were selected as the control group.All subjects were examined by CDFI and ABI.CDFI parameters(arterial diameter,intima-media thickness,resistance index),positive rate of CDFI and positive rate of ABI in different parts of the two groups were compared.The results of digital subtraction angiography were used as the gold standard to evaluate the diagnostic efficacy of CDFI,ABI and their combination in DF patients with lower extremity arterial disease.Results The inner diameters of posterior tibial artery,anterior tibial artery,and dorsalis pedis artery in DF group were significantly lower than those in control group.Intima-media thickness and resistance index of deep femoral artery,posterior tibial artery,superficial femoral artery,popliteal artery,anterior tibial artery and dorsalis pedis artery in DF group were significantly higher than those in control group.The results of digital subtraction angiography showed that 85 cases(85.00%)of lower extremity arterial disease were found in 100 patients in DF group,including 34 cases of occlusion,41 cases of plaque,and 10 cases of stenosis.The detection rates of intima-media thickening,plaque and occlusion in DF group were significantly higher than those in control group.The positive rate of ABI<0.9 in DF group was significantly higher than that in control group,and the positive rate of 0.9-1.3 in DF group was significantly lower than that in control group.The sensitivity,negative predictive value and accuracy of CDFI combined with ABI in the diagnosis of DF patients with lower extremity arterial disease were higher than those of single diagnosis,and the difference was statistically significant(P<0.05).Conclusi

关 键 词：糖尿病足 下肢动脉病变 彩色多普勒超声 踝臂指数 

分 类 号：R445[医药卫生—影像医学与核医学]