王丽

【摘要】 目的：观察彩色多普勒超声检查高血压合并糖尿病患者颈动脉粥样硬化的超声图像特点，探讨其使用价值。方法：对2018年10月-2020年10月于本院就诊确诊的182例高血压、糖尿病患者颈动脉彩色多普勒超声检查资料进行回顾性分析，其中单纯高血压患者58例为A组，单纯糖尿病患者65例为B组，高血压合并糖尿病患者59例为C组，选取同时期于本院进行健康体检的正常人群60例为对照组。所有患者均进行颈动脉彩色多普勒超声检查，比较各组的颈动脉粥样硬化检出情况及斑块发生时的血流情况。结果：A、B、C组三组颈动脉内中膜厚度、颈动脉分叉处内中膜厚度均高于对照组，且C组最高，四组比较差异均有统计学意义（P<0.05）。A、B、C组PSV、EDV均低于对照组，RI、PI均高于对照组，其中C组的PSV、EDV均低于A、B组，RI、PI均高于A、B组，差异均有统计学意义（P<0.05）。结论：高血压合并糖尿病患者发生颈动脉粥样硬化率远远高于正常人群及单纯高血压、糖尿病患者，且颈动脉彩色多普勒超声检查简单无创，值得在临床早期诊断中推广应用。

【关键词】 高血压 糖尿病 颈动脉 彩色多普勒超声

[Abstract] Objective： To observe the characteristics of color Doppler ultrasound in detecting carotid atherosclerosis in patients with hypertension and diabetes mellitus， to explore its application value. Method： The carotid color Doppler ultrasound data of 182 patients with hypertension and diabetes diagnosed in our hospital from October 2018 to October 2020 were retrospectively analyzed. Among them， 58 patients with hypertension alone were classified as group A， 65 patients with diabetes alone as group B， 59 patients with hypertension combined with diabetes mellitus as group C， 60 cases of healthy people in our hospital at the same time were selected as the control group. All patients were examined by color Doppler ultrasound， the detection of carotid atherosclerosis and the blood flow of plaque in each group were compared. Result： Carotid intima-media thickness and carotid bifurcation intima-media thickness in group A， B and C were higher than those in control group， group C was the highest， the differences were statistically significant （P<0.05）. PSV and EDV of group A， B and C were lower than those of control group， RI and PI were higher than those of control group， PSV and EDV of group C were lower than those of group A and B， RI and PI were higher than those of group A and B， the differences were statistically significant （P<0.05）. Conclusion： The incidence of carotid atherosclerosis in patients with hypertension and diabetes mellitus is much higher than that in normal people and patients with simple hypertension and diabetes mellitus， the color Doppler ultrasound examination of carotid artery is simple and noninvasive， which is worthy of promotion and application in early clinical diagnosis.

[Key words] Hypertension Diabetes mellitus Carotid artery Color Doppler ultrasound

First-authors address： Fengcheng Central Hospital， Fengcheng 118100， China

doi：10.3969/j.issn.1674-4985.2021.09.037

隨着人们生活水平的提高，工作、学习压力也随之而来，使得高血压、糖尿病发病率越来越多，而且逐渐趋于年轻化，逐步发展为近年来临床常见病[1-3]。由于糖尿病、高血压属于慢性疾病，病程较长，需要人们长期药物、饮食控制，部分患者的治疗依从性较差，伴随而来的并发症也日益增多，严重威胁着人类健康，其中动脉粥样硬化最为危险[4-5]。糖尿病、高血压患者均容易并发血管病变，所以早期发现动脉壁损害对识别是否发生动脉粥样硬化有着重要的意义。近期研究表明，动脉粥样硬化与颈动脉之间存在密切联系，颈动脉可作为直接反映全身动脉改变的重要标志[6-10]。本文选取2018年10月-2020年10月于本院就诊的单纯高血压患者、单纯糖尿病患者及高血压合并糖尿病患者颈动脉彩色多普勒超声检查结果进行回顾性分析，以其为临床早期诊断并预防动脉粥样硬化发生提供诊断依据，现报道如下。……