血管回声跟踪技术评价2型糖尿病外周血管功能

Evaluation of type 2 diabetes with peripheral atherosclerosis by using echo-tracking

摘要:

目的：探讨利用血管回声跟踪技术（echo tracking，ET）评价2型糖尿病外周血管功能及其检测参数的影响因素，为临床早期防治糖尿病患者外周血管病变提供科学依据。方法：选取确诊2型糖尿病患者128例，并随机选择健康志愿者120例，应用ET技术检测糖尿病组和正常对照组患者压力-应变弹性系数（pressure-strain elasticity coefficients，Ep）、硬化参数β（stiff－ness parameter β，SPβ）、动脉顺应性（arterial compliance，AC）、脉搏波传导速度β（pulse wave velocity β，PWVβ）、管径增大指数（augmentation index，AI）以及血管功能指标收缩期内径（systolic diameter，Ds）、舒张期内径（diastolic diameter，Dd）和内中膜厚度（intima media thickness，IMT）的变化情况，并定量评价2型糖尿病患者的外周颈、股和肱动脉的血管功能，同时利用病例基本信息对E-tracking参数的影响因素进行分析。结果：糖尿病组颈、股和肱动脉的Ep、SPβ和PWVβ值均高于对照组（P<0.05）；颈、股动脉的AC值却均明显低于对照组（P<0.05）。在年龄、病程、空腹血糖、餐后2 h血糖、甘油三酯、总胆固醇等因素中，影响ET参数的主要因素包括年龄、病程及总胆固醇。其中，Ep、SPβ和PWVβ均与年龄和病程呈正相关（P<0.05），而AC则与年龄、病程呈负相关（P<0.05），与总胆固醇呈正相关（P<0.05），AI与年龄呈正相关（P<0.05）。结论：ET技术检测可用于评价2型糖尿病患者外周血管粥样硬化程度，且其检测指标的主要影响因素是患者年龄和病程。该技术能准确评价糖尿病患者外周血管的功能性或病理学改变，对疾病的早期防治和临床疗效的评估有十分重要的意义。

Abstract:

Objective：To apply the echo-tracking（ET） to evaluate the peripheral artery function，to explore the influencing factors of detecting parameters of patients with type 2 diabetes and to provide scientific basis for early clinical prevention and treatment of dia－betic patients with peripheral vascular disease. Methods：Totally 128 patients with type 2 diabetes were taken as diabetic group and 120 health volunteers were recruited as control group in this study. ET technology was used to detect pressure-strain elasticity coeffi－cients（Ep），stiffness parameter β（SPβ），arterial compliance（AC），pulse wave velocity β （PWVβ），augmentation index（AI） and sys－tolic diameter（Ds），diastolic diameter（Dd） and intima media thickness（IMT） both in diabetic group and control group. Vascular function in the carotid，femoral and brachial artery was quantitatively evaluated and influencing factors of ET were analyzed by using basic information of the cases. Results：Values of Ep，SPβ and PWVβ in the arotid，femoral and brachial artery in diabetes group were significantly higher than those in controls（P<0.05）. AC values in the arotid，femoral artery were significantly lower in diabetes group than in control group（P<0.05）. Among the factors of age，duration of diabetes，fasting glucose，2 h postprandial blood glucose，triglycerides，total cholesterol and other factors，the main influencing factors were age，duration and total cholesterol. Ep，SPβ and PWVβ were positively correlated with age and diabetes duration（P<0.05）. AC values were negatively related with age and duration（P<0.05） but were positively correlated with total cholesterol（P<0.05）. Also，AI values were positively correlated with age（P<0.05）. Conclusion：ET can be used for the evaluation of type 2 diabetes patients with peripheral atherosclerosis，and the main influencing factors of its detection indicators are age and disease duration. This method can accurately evaluate the functional or pathological changes in type 2 diabetes patients with peripheral atherosclerosis and it is of great significance for early prevention and treatment of the diabetes.