彩色多普勒超声诊断不同病程老年2型糖尿病下肢血管病变的临床价值及与血清ET、NO的关系研究

摘要 目的：探讨彩色多普勒超声诊断不同病程老年2型糖尿病(T2DM)下肢血管病变(LEADDP)的临床价值及与血清内皮素(ET)、一氧化氮(NO)的关系。方法：选取我院于2019年5月~2020年4月期间收治的80例老年T2DM合并LEADDP患者为观察组，根据不同病程分为3组，<10年组30例，10~20年组33例，>20年组17例，另选取同时期我院收治的50名老年单纯T2DM患者为对照组，所有受检者均接受彩色多普勒超声检查，并检测血清ET、NO水平。对比观察组与对照组足背动脉狭窄发生率，对比不同病程患者LEADDP检出率，对比不同病程患者及对照组的动脉血管内径、动脉血流量及血清ET、NO水平，Pearson相关性分析动脉血管内径、动脉血流量与血清ET和NO水平的相关性。结果：观察组足背动脉狭窄发生率明显高于对照组(P<0.05)；不同病程患者LEADDP检出率随着病程延长而增加(P<0.05)；不同病程患者动脉血管内径、动脉血流量、NO水平随着病程的的延长而降低，ET水平随着病程的延长而升高(P<0.05)；Pearson相关性分析显示，动脉血管内径、动脉血流量与血清ET水平呈负相关，与NO水平呈正相关(P<0.05)。结论：老年T2DM合并LEADDP患者存在明显的下肢动脉管径狭窄和血流量缓慢，病变程度随着病程延长而增加，与血清ET、NO水平有密切关系，彩色多普勒超声诊断可有效评价其病变程度。

The Clinical Value of Color Doppler Ultrasonography in the Diagnosis of Lower Extremity Vascular Diseases in Elderly Type 2 Diabetes Mellitus with Different Course and Its Relationship with Serum ET and NO

ABSTRACT Objective: To explore the clinical value of color Doppler ultrasound in diagnosing lower extremity angiopathy (LEADDP) in elderly patients with type 2 diabetes mellitus (T2DM) with different course and its relationship with serum endothelin (ET) and nitric oxide (NO). Methods: 80 patients with elderly T2DM combined with LEADDP who were admitted in our hospital from May 2019 to April 2020 were selected as the observation group, and were divided into 3 groups according to different disease courses, 30 cases in the <10 years group, and 33 cases in the 10~20 years group, 17 cases in the >20 years group. 50 patients with elderly simple T2DM who were admitted to our hospital at the same period were selected as the control group. All the subjects were examined by color Doppler ultrasound, and the serum ET and NO levels were detected. The incidence of dorsal plantar stenosis in the observation group and the control group were compared, the detection rate of LEADDP in patients with different disease courses were compared, the arterial blood vessel diameter and arterial blood flow, serum ET and NO levels in patients with different disease courses and the control group were compared, and Pearson correlation was used to analyze the correlation between arterial vessel diameter, arterial blood flow and serum ET and NO levels. Results: The incidence of dorsal plantar stenosis in the observation group was significantly higher than that in the control group (P<0.05). The detection rate of LEADDP in patients with different course disease increased with the extension of the disease course (P<0.05). The arterial blood vessel diameter, arterial blood flow, NO level in patients with different course of disease decreased with the extension of the course of disease, ET level increased with the extension of the course of disease (P<0.05). Pearson correlation analysis showed that the arterial blood vessel diameter and arterial blood flow were negatively correlated with serum ET levels, and positively correlated with NO levels (P<0.05). Conclusion: Patients with elderly T2DM combined with LEADDP have obvious lower extremity arterial diameter stenosis and slow blood flow. The degree of disease increases with the course of the disease. It is closely related to serum ET and NO levels. Color Doppler ultrasound diagnosis can effectively evaluate the disease degree.