何翠玲 孙振杰 樊筱军

[摘要] 目的 分析高頻超声技术检测2型糖尿病（T2DM）患者指、趾尖动脉血流参数及其在早期血管病变中的筛查价值。 方法 选取2016年3月～2017年3月唐山市工人医院分院（以下简称“我院”）90例T2DM患者为T2DM组，其中患病时间1～3年48例，>3～9年22例，>9～<16年11例，≥16年9例。选择同期于我院体检健康者90名为对照组。通过高频超声技术检测两组指、趾尖动脉血流参数的情况。 结果 T2DM组患病时间为>3～9年、>9～<16年及≥16年的患者指尖动脉阻力指数明显高于对照组，血流量显著低于对照组，差异均有统计学意义（P < 0.05）；T2DM组患病时间>9～<16年和≥16年的患者指尖末梢动脉血管内径均明显低于对照组，差异均有统计学意义（P < 0.05）；T2DM组患病时间为>3～9年、>9～<16年、≥16年的患者趾尖末梢动脉的阻力指数明显高于对照组，血管内径与血流量均明显低于对照组，差异均有统计学意义（均P < 0.05）。 结论 利用高频超声技术能够有效检测T2DM患者的指、趾尖动脉血流参数的情况，有助于筛查患者早期血管病变，故此有着重要的评估价值。

[关键词] 高频超声技术；2型糖尿病；血流参数；血管病变；筛查价值

[中图分类号] R587.2 [文献标识码] A [文章编号] 1673-7210（2018）08（a）-0131-04

[Abstract] Objective To analyze the detection of high frequency ultrasonography in blood flow parameters of finger， toe tip artery and screening value of early vascular disease in patients with type 2 diabetes mellitus （T2DM）. Methods From March 2016 to March 2017， 90 cases of T2DM in the Workers′ Hospital of Tangshan City （"our hospital" for short） were selected as the T2DM group， among them， there were 48 cases with the disease duration of 1-3 years， 22 cases with > 3-9 years， 11 cases with >9-<16 years， and 9 cases with ≥ 16 years. Ninety healthy subjects in our hospital were selected as the control group at the same period. The blood flow parameters of finger and toe tip artery were detected by high frequency ultrasonography in the each group. Results The resistance index of finger tip artery in patients with the disease duration of >3-9 years， >9-<16 years and ≥ 16 years in the T2DM group were significantly higher than those in the control group， and the blood flow were significantly lower than those in the control group， the differences were statistically significant （P < 0.05）. The finger tip peripheral arterial vascular diameter for patients with the disease duration of >9-<16 years and ≥ 16 years in the T2DM group were significantly lower than those in the control group， the differences were statistically significant （P < 0.05）. The resistance index of toe tip artery for patients with the disease duration >3-9 years， >9-<16 years and ≥ 16 years in the T2DM group were significantly higher than those in the control group， and the vascular diameter and blood flow were significantly lower than those in the control group， the differences were statistically significant （P < 0.05）. Conclusion Using high frequency ultrasonography can effectively detect the blood flow parameters of finger and toe tip artery in patients with T2DM， which can help to screen the early vascular lesion， so it has important assessment value.

[Key words] High frequency ultrasonography； Type 2 diabetes mellitus； Blood flow parameter； Vascular disease； Screening value

2型糖尿病（T2DM）在近几年来的发病率呈现逐年升高的趋势，且随着疾病程度的加重，会发生诸多并发症如心血管疾病、肢体坏疽、脑血管意外、肾功能衰竭、失明等，对患者的生命安全造成极大威胁，其中血管并发症较为严重[1-3]。有研究表明，糖尿病所导致的血管病变的主要特征是微循环障碍、微血管中血管瘤的形成和微血管中基底膜的增厚。虽然确切的机制尚未得到完全证实，但现有的资料表明糖尿病患者的高血糖、蛋白激酶C的激活、血流动力学改变及代谢旁路增强等都涉及到糖尿病患者微血管病变的机制当中[4-6]，并且微血管功能障碍也可以作为预测糖尿病的临床标志[7-8]。磁共振血管成像与数字减影血管造影术均是目前检测血管病变的重要手段，尽管两种检测方法的准确性相对较高，但其费用较高，并且有着一定的创伤性，同时难以筛查早期微血管病变情况[9-10]，故此较难在临床中得到广泛应用。此外，血管病变相关的实验室检测指标亦是检测血管病变的重要方法，虽能够发现患者血管病变情况，但因其敏感性较低，故难以预测早期血管病变[11]。高频彩色……