CAJ | 학술논문

目的探讨血管回声追踪(ET)技术评价2型糖尿病患者股动脉弹性的价值.方法采集30例正常人和54例2型糖尿病患者股动脉的二维超声图像,测量双侧股动脉内膜-中层厚度(IMT),血管内径(D);应用脉冲多普勒技术(PW)测量收缩期流速(Vs)、舒张早期反向流速(Vr)、舒张末期正向流速(Vd)、阻力指数(RI)、搏动指数(PI);应用ET技术检测弹性指标:僵硬度指数(β)、血管压力-应变弹性系数(Ep)、顺应性(AC)、增大指数(AI)、脉搏波传导速度(PWVβ).结果按照IMT是否＜1.0 mm分组后显示:糖尿病IMT＜ 1.0 mm组及糖尿病IMT≥1.0 mm组的股动脉血流动力学参数RI、PI、Vr及弹性指标β、Ep、PWVβ均较对照组显著增高(P＜0.05),AC值显著降低(P＜0.05)；糖尿病IMT≥1.0 mm组的股动脉血流动力学参数RI、PI与IMT＜1.0 mm组比较差异无统计学意义,但弹性指标β、Ep、PWVβ较糖尿病IMT＜1.0 mm组显著增高(P＜0.05).结论糖尿病患者存在动脉硬化,且在血管粥样硬化的形态学改变出现之前,血管壁弹性功能已降低,且影响血流动力学,造成外周组织血液供应不良.
목적 탐토혈관회성추종(ET)기술평개2형당뇨병환자고동맥탄성적개치.방법 채집30례정상인화54례2형당뇨병환자고동맥적이유초성도상,측량쌍측고동맥내막-중층후도(IMT),혈관내경(D);응용맥충다보륵기술(PW)측량수축기류속(Vs)、서장조기반향류속(Vr)、서장말기정향류속(Vd)、조력지수(RI)、박동지수(PI);응용ET기술검측탄성지표:강경도지수(β)、혈관압력-응변탄성계수(Ep)、순응성(AC)、증대지수(AI)、맥박파전도속도(PWVβ).결과 안조IMT시부＜1.0 mm분조후현시:당뇨병IMT＜ 1.0 mm조급당뇨병IMT≥1.0 mm조적고동맥혈류동역학삼수RI、PI、Vr급탄성지표β、Ep、PWVβ균교대조조현저증고(P＜0.05),AC치현저강저(P＜0.05)；당뇨병IMT≥1.0 mm조적고동맥혈류동역학삼수RI、PI여IMT＜1.0 mm조비교차이무통계학의의,단탄성지표β、Ep、PWVβ교당뇨병IMT＜1.0 mm조현저증고(P＜0.05).결론 당뇨병환자존재동맥경화,차재혈관죽양경화적형태학개변출현지전,혈관벽탄성공능이강저,차영향혈류동역학,조성외주조직혈액공응불량.
Objective To investigate the elasticity and hemodynamics of femoral artery in patients with type 2 diabetes mellitus (T2DM).Methods Subjects recruited in this study were divided into three groups,healthy control ( n =30),T2DM patients with femoral arterial intima-media thickness(IMT) ＜1.0mm ( n =32) and IMT≥1.0 mm( n =22).The IMT and diameter were measured by two-dimensional ultrasound.The blood velocity in early and late systolic stages and early diastolic reverse blood velocity,resistance index and pulsatile index were measured by pulse Doppler.The stiffness parameter,pressurestrain elasticity modulus,arterial compliance,argumentation index and one-point pulse wave velocity were measured by echo-tracking technique.Results The early diastolic reverse blood velocity,resistance index,pulsatile index,stiffness parameter,pressure-strain elasticity modulus and one-point pulse wave velocity were significantly elevated in T2DM patients compared with healthy control (P ＜ 0.05),the arterial compliance was significantly lower in T2DM subjects.Stiffness parameter,pressure-strain elasticity modulus and one-point pulse wave velocity were more pronounced in the patients with IMT≥1.0 mm than those with IMT ＜ 1.0 mm ( P ＜0.05).Conclusions There is atherosclerosis in femoral arteries in patients with T2DM.A decrease in arterial elasticity occurs prior to the morphological changes in vascular atherosclerosis,the arterial elasticity abnormality causes insufficient blood supply to peripheral tissues.