胫前动脉血管内皮功能及血流动力学参数评价2 型糖尿病下肢动脉病变

目的:探讨胫前动脉血管内皮舒张功能及血流动力学参数与2型糖尿病下肢疾病的相关性,为2型糖尿病下肢动脉病变的超声诊断提供更多的理论依据。方法:本研究设计经伦理审查委员会批准,所有研究对象在检查前均已签署知情同意书。将159例2型糖尿病患者分为下肢动脉病变(Peripheral Arterial Disease,PAD)症状组(具有间歇性跛行和(或)静息性腿痛)和无PAD症状组,使用高频超声二维时分别测量静息状态下及反应性充血后胫前动脉内径(D0,D1),内-中膜厚度(Intima Media Thickness,IMT),彩色流速流量定量技术测量胫前动脉收缩期峰值血流速度(Peak systolic Velocity,PSV),搏动指数(Pulse Index,PI),血管内压力(Pression,P)及压差(Friqunent,FRQ),比较两组胫前动脉血管内皮舒张功能((D1-D0)/D0),IMT及血流参数的差异,应用多元回归分析血管内皮舒张功能及以上血流动力学参数与下肢PAD症状的相关性。结果:(1)与非PAD症状组相比,PAD症状组血管内皮舒张功能,PSV、PI、P均减低,IMT增加;(2)PAD症状与年龄、病程、糖化血红蛋白、PSV、PI、Sten%、血管内皮舒张功能等有相关性,而与IMT等无相关性。结论:(1)袖带加压法测定血管内皮依赖性舒张功能方法简便且有潜在临床适用性;(2)血管内皮舒张功能作为一项新指标可以和经典的PSV一样反映下肢动脉病变的情况,从而为下肢动脉病变的诊断提供依据。

Clinical Evaluation of Peripherial Arterial Diseases with Anterior TibialArterial Endothelial Function and Hemodynamic Parametersin Type 2 Diabetic Patients

Objective: To study the anterior tibial arterial endothelial before diastolic function and hemodynamic parameters and type 2 diabetes lower limbs the correlation of disease,type 2 diabetes lower limb artery pathological changes of ultrasound diagnosis for more theoretical basis.Methods: The institutional review board approved the study,and all patients provided signed informed consent.159 cases of type 2 diabetic patients were divided into peripheral arterial disease(PAD) symptoms group(with(intermittent claudication and(or) rest pain) and no PAD symptoms group,All patients underwent high frequency ultrasound when 2D mode,measured the resting state and reactive hyperemia tibial arterial inner diameter(D0,D1),intima media thickness(IMT),color doppler flow imaging(CDFI) and PW mode to measure the peak systolic velocity(PSV),pulse index(PI),the pressure(P) and Friqunent(FRQ),compared two groups with anterior tibial arterial endothelial diastolic function((D1-D0)/D0),IMT and the hemodynamic parameters,make out the differences and multiple regression analysis,then list the correlation between the application of vascular endothelial diastolic function and hemodynamic parameters with PAD symptoms.Results: 1) Compared with the NPAD symptoms group,in PAD symptoms group,endothelial diastolic function,PSV,PI,P were decreased and IMT increased;2) PAD symptoms had correlation with age,course of diseases glycated hemoglobin,PSV,PI,Sten %,endothelial diastolic function etc,but had no correlation with IMT,etc.Conclusion: 1) The cuffs compression method to determine the vascular endothelial dependence method is simple and diastolic function has potential clinical applicability;2) aterial endothelial diastolic function and as a new index can reflect PAD changes as the classic index of PSV,provides the basis for diaganosis.