多普勒超声与炎症指标诊断T2DM患者下肢血管病变的价值  

Value of Doppler ultrasound and inflammatory markers in diagnosis of lower limb vascular lesions in patients with type 2 diabetes mellitus

作　　者：刘雪妮 惠容容 邓庆 Liu Xueni;Hui Rongrong;Deng Qing(Department of Ultrasonography,Yan'an City Traditional Chinese Medicine Hospital,Yan'an 716000,China;Department of Endcrinology,Nuclear Industry 215 Hospical of Shanxi Province,Xianyang 727000,China)

机构地区：[1]延安市中医医院超声科,延安716000 [2]陕西省核工业二一五医院内分泌科,咸阳727000

出　　处：《国际医药卫生导报》2025年第8期1337-1342,共6页International Medicine and Health Guidance News

基　　金：陕西省自然科学基础研究计划(2022JQ-769)。

摘　　要：目的探讨多普勒超声联合炎症指标诊断2型糖尿病(type 2 diabetes mellitus,T2DM)患者下肢血管病变的价值。方法选取2019年1月至2024年1月延安市中医医院收治的T2DM合并下肢血管病变患者185例为观察组,选取同期T2DM无下肢血管病变患者50例为对照组。对照组男26例(52.00%),女24例(48.00%),年龄(65.24±3.64)岁,病程(8.53±1.64)年。观察组男102例(55.14%),女83例(44.86%),年龄(65.57±3.57)岁,病程(8.64±1.35)年。两组研究对象均接受多普勒超声检查。比较两组下肢血流动力学指标、下肢动脉粥样硬化斑块形成率、斑块发生位置及足背动脉狭窄情况。采集两组研究对象血液样本,检测血清生化指标及炎症指标水平。采用受试者操作特征曲线(ROC)对多普勒超声指标及炎症因子水平诊断T2DM患者下肢血管病变的价值进行分析。采用χ^(2)检验、t检验进行统计分析。结果观察组股动脉、腘动脉、足背动脉血流峰值流速均低于对照组[(120.88±0.95)cm/s比(135.15±0.88)cm/s、(71.93±0.45)cm/s比(79.65±0.31)cm/s、(33.64±1.11)cm/s比(42.42±1.35)cm/s],差异均有统计学意义(t=95.679、114.122、47.300,均P<0.05)。观察组股动脉、腘动脉、足背动脉的搏动指数均高于对照组(5.56±1.22比4.59±1.12、6.31±1.12比5.54±1.23、8.21±1.14比7.52±1.05),差异均有统计学意义(t=5.073、4.223、3.860,均P<0.05)。对照组胫前动脉、胫后动脉、足背动脉、股动脉、腘动脉狭窄血管段数少于观察组,足背动脉狭窄程度低于观察组,差异均有统计学意义(χ^(2)=44.023、165.489,均P<0.05)。观察组低密度脂蛋白胆固醇、糖化血红蛋白水平分别为(3.55±0.51)mmol/L、(8.78±1.12)%,均高于对照组的(2.78±0.47)mmol/L、(7.57±0.85)%,差异均有统计学意义(t=9.626、7.102,均P<0.05)。观察组血清白蛋白、25羟基维生素D3[25(OH)D]水平分别为(33.21±4.38)g/L、(19.37±3.65)µg/L,均低于对照组的(39.34±5.31)g/L、(25.12±4.38)�Objective To explore the value of color Doppler ultrasound combined with inflammatory markers in the diagnosis of lower limb vascular lesions in patients with type 2 diabetes mellitus(T2DM).Methods From January 2019 to January 2024,185 patients with T2DM and lower limb vascular lesions treated at Yan'an City Traditional Chinese Medicine Hospital were selected as an observation group,and 50 T2DM patients without lower limb vascular lesions a control group.There were 26 males(52.00%)and 24 females(48.00%)in the control group;they were(65.24±3.64)years old;their disease course was(8.53±1.64)years.There were 102 males(55.14%)and 83 females(44.86%)in the observation group;they were(65.57±3.57)years old;their disease course was(8.64±1.35)years.Both groups underwent color Doppler ultrasound examination.The lower limb hemodynamic parameters,the rates of lower limber atherosclerotic plaque formation,plaque locations,and dorsalis pedis arterial stenosis were compared between the two groups.The blood samples from both groups were detected for serum biochemical and inflammatory marker levels.The diagnostic value of Doppler ultrasound parameters and levels of inflammatory markers for lower limb vascular lesions in the patients was assessed using the receiver operating characteristic curve(ROC).χ^(2) and t tests were used for the statistical analysis.Results The peak flow velocities of the femoral,popliteal,and dorsalis pedis arteries in the observation group were lower than those in the control group[(120.88±0.95)cm/s vs.(135.15±0.88)cm/s,(71.93±0.45)cm/s vs.(79.65±0.31)cm/s,and(33.64±1.11)cm/s vs.(42.42±1.35)cm/s],with statistical differences(t=95.679,114.122,and 47.300;all P<0.05).The pulsatility indices of the femoral,popliteal,and dorsalis pedis arteries in the observation group were higher than those in the control group(5.56±1.22 vs.4.59±1.12,6.31±1.12 vs.5.54±1.23,and 8.21±1.14 vs.7.52±1.05),with statistical differences(t=5.073,4.223,and 3.860;all P<0.05).The stenotic segments of anterior tibial artery

关 键 词：2型糖尿病 下肢血管病变 多普勒超声 炎症指标 诊断价值 

分 类 号：R587.2[医药卫生—内分泌]