超声造影定量分析与糖尿病患者胰岛素抵抗及足部血液流变指标的相关性  

Correlation between quantitative analysis of contrast-enhanced ultrasound and insulin resistance and foot blood rheology indices in diabetic patients

作　　者：张焕萍 张乾 赵俊香 ZHANG Huan-ping;ZHANG Qian;ZHAO Jun-xiang(Department of Ultrasound,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei,Cangzhou 061000,Hebei,China)

机构地区：[1]河北省沧州中西医结合医院超声科,河北沧州061000 [2]任丘市人民医院内科,河北任丘062550

出　　处：《广东医学》2024年第10期1306-1311,共6页Guangdong Medical Journal

基　　金：河北省卫生健康委员会科技计划项目(20220608)。

摘　　要：目的探讨超声造影定量分析与糖尿病足患者胰岛素抵抗及足部血液流变指标的相关性。方法前瞻性选取2020年12月至2022年1月期间80例糖尿病微血管病变患者为病变组,40例糖尿病患者为DM组,42例接受体检的作为对照组,均接受超声造影和彩色多普勒超声检查。分析超声造影定量指标、胰岛素抵抗水平以及足部血液流变指标。采用Pearson相关性分析超声造影定量分析糖尿病患者胰岛素抵抗和足部血液流变指标的相关性。结果超声造影定量指标中平均峰值强度(PI)、时间-强度曲线下面积(AUC)分别低于DM组和对照组,右足趾对比剂到达时间(AT)、达峰时间(TTP)高于DM组和对照组(P<0.05);胰岛素抵抗指标中病变组空腹血糖(FPG)、糖化血红蛋白(HbA1C)、餐后2 h血糖(2hFPG)、空腹胰岛素(FINS)水平、胰岛素抵抗指数(HOMA-IR)均高于DM组和对照组,HOMA-β低于DM组和对照组(P<0.05),足部血液流变指标中病变组D、收缩期峰值速度(PSV)、舒张末期速度(EDV)、动脉脉动指数(ARI)、动脉阻力指数(API)均低于DM组和对照组(P<0.05)。结论超声造影定量分析与胰岛素抵抗和足部血液流变指标具有相关性,且FPG与PI、AUC呈负相关,AUC与D、PSV呈正相关,FPG与D、PSV呈负相关。Objective To explore the correlation between quantitative analysis of contrast-enhanced ultrasound and insulin resistance and foot blood rheology indices in patients with diabetic foot.Methods A prospective study was conducted from December 2020 to January 2022,involving 80 patients with diabetic microvascular complications(lesion group),40 diabetic patients(DM group),and 42 healthy controls.All participants underwent contrast-enhanced ultrasound and color Doppler ultrasound examinations.The study analyzed quantitative ultrasound indices,levels of insulin resistance,and foot blood rheology parameters.Pearson correlation analysis was used to evaluate the relationships among these factors.Results The average peak intensity(PI)and area under the time-intensity curve(AUC)in the lesion group were significantly lower than those in the DM and control groups,while the time for contrast to reach the right toe(AT)and time to peak(TTP)were higher(P<0.05).In insulin resistance indicators,the lesion group showed higher fasting blood glucose(FPG),glycated hemoglobin(HbA1C),2-hour postprandial blood glucose(2hFPG),fasting insulin(FINS),and insulin resistance index(HOMA-IR),with lower HOMA-βcompared to the DM and control groups(P<0.05).Foot blood rheology indices such as D,peak systolic velocity(PSV),end-diastolic velocity(EDV),arterial pulsatility index(ARI),and arterial resistance index(API)were all lower in the lesion group than in the DM and control groups(P<0.05).Conclusion There is a correlation between quantitative analysis of contrast-enhanced ultrasound and insulin resistance and foot blood rheology indices.Specifically,FPG is negatively correlated with PI and AUC,while AUC is positively correlated with D and PSV.Additionally,FPG is negatively correlated with D and PSV.

关 键 词：糖尿病 胰岛素抵抗 超声造影定量分析 足部血液流变指标 相关性 

分 类 号：R4[医药卫生—临床医学] R44