摘要
目的研究指、趾腹小动脉和甲床微动脉的结构及血流动力学参数,评价糖尿病患者手指、足趾端微循环状态。方法73例2型糖尿病患者按病程分为3组,正常对照组40例。采用e-Flow成像显示末节指、趾腹小动脉和甲床微动脉,获得多普勒指标;用血管像素比估算血管数量。结果①大部分的指、趾甲床动脉走行方向与手指、足趾平行,纵行的动脉间有横行的动脉支穿插吻合。②糖尿病Ⅱ、Ⅲ组末节指、趾腹和甲床内微小动脉稀少,血流频谱呈高阻波形。③糖尿病Ⅰ组指/趾甲床动脉和趾腹动脉舒张期血流速度(EDV)低于对照组(P<0.05);阻力指数(RI)高于对照组(P<0.05/P<0.01);趾甲床动脉平均血管像素比低于对照组(P<0.05);④糖尿病Ⅱ、Ⅲ组指、趾甲床动脉及趾/指腹动脉收缩期最大流速(PSV)、EDV、平均血管像素比低于对照组(P<0.01/P<0.05);RI高于对照组(P<0.01);⑤糖尿病各组及对照组趾甲床动脉/趾腹动脉PSV、EDV、平均血管像素比低于同组手指相同指标P<0.01;RI高于同组手指相同指标P<0.05/P<0.01。结论糖尿病早期(病程5年内)即可出现指、趾端微血管血流动力学改变,晚期血管数量减少。肢端末梢微血管受损早于肢端缺血症状的出现。趾端血管损害出现较指端更早,程度更重。e-Flow可作为评价肢端早期微血管病变的有效方法。
Objective To study the anatomic structures and the hemodynamics parameters of small artery of digit tip or arteriole on nail bed; To evaluate the microcirculation of digit tip in type 2 diabetic. Methods The small arteries in digit tip and arteriole on nail bed of 73 case of diabetic divided into three groups according to the course of diseases and 40 normal adults setup as a control group were imaged and their hemodynamics parameters were measured by -Flow imaging. The amount of arteries was assessed by calculating their pixel. Results （1）The way of most arteriole on nail bed were parallel with finger and toe and there are transverse branch among longitudinal arteries. （2）In the diabetes group Ⅱ , Ⅲ there are less arteriole on nail bed of finger and toe and the blood flow frequency spectrum present a high block waveform. （3）In the diabe- tes groupⅠ , contrasted with control group, the EDV of small arteris in finger tip and toe tip and arteriole on nail bed of toe decreased （P〈0.05） and RI increased remarkably （P〈0.05/P〈0.01） ; The average pixel of arteriole on nail bed of toe decreased （P（0. 05）. （3）In the diabetes group Ⅱ ,Ⅲ, the PSV, EDV, average pixel of small arteris in finger tip and toe tip and arteriole on nail bed are lower （P〈0. 01/P〈0.05） and RI are higher （P〈0.01） than that of control group. PSV, EDV, average pixel of small artery and arteriole on nail bed of toe tip were lower （P〈0.01） and RI were higher （P〈0.01/ P〈0.05） than same mark of finger significantly in every groups of diabetes and control group. Conclusion The changes of hemodynamics parameters of arteriole of digit tip can occur within 5 years after diabetes come on. The amount of ateries reduced in advanced stage. The arteriole injure of the end of extremity happen earlier than ischemia symptom. The arteriole damage in toe tip occur earlier and more strictly than that in finger, e-Flow can be used as a efficient method to evaluate early arteriole pathological changes in the end of extremity.
出处
《中国医学影像技术》
CSCD
北大核心
2007年第9期1327-1329,共3页
Chinese Journal of Medical Imaging Technology
