摘要
目的应用18 MHz高频彩色多普勒超声检查T2DM患者的足背动脉,预测T2DM患者糖尿病足的发生情况。方法选取2014年10月至2016年8月进行常规体检的T2DM患者188例。由专业医生按照具体情况分为并发糖尿病足组(59例)和未并发糖尿病足组(129例)。详细记录患者的一般临床资料,包括性别、年龄、BMI、糖尿病病程等。采集血样,进行血糖水平和炎性指标的测定,包括空腹血糖值(FPG),餐后2 h血糖值(2 hPG),糖化血红蛋白(HbA1c),白细胞计数(WBC)和C-反应蛋白(CRP)。然后使用18MHz高频彩色多普勒超声技术对患者的足背动脉进行检查。分别测量血流量(BF)、动脉直径(BD)、内中膜厚度(IMT)、峰值流速(PFV)、舒张末期流速(EDV)、平均流速(MFV)和搏动指数(PI)。把2组的各项指标进行比较,对于存在显著差异的一般临床参数和超声检查结果进行相关性分析。并对相关系数最大的指标绘制ROC曲线。结果 2组患者的性别、年龄、BMI、FPG无显著差异(P>0.05);病程长短、2hPG、HbA1c、WBC和c RP存在显著差异(P<0.05);超声结果 BF、BD、IMT、EDV、MFV均无显著差异(P>0.05);并发糖尿病足组的PSV和PI均低于未并发糖尿病足组,差异有统计学意义(P<0.05)。相关性分析中,PSV与HbA1c呈负相关(P<0.05),PI与HbA1c、WBC、CRP呈负相关(P<0.05)。并对相关系数r最大的PSV与HbA1c绘制ROC曲线,比较预测T2DM糖尿病足发生的诊断效能。PSV的曲线下面积为0.803,临界点为38.00 cm/s时,敏感性92.2%,特异性62.7%;HbA1c的曲线下面积0.621,临界点为6.93%时,敏感性83.1%,特异性40.3%。结论 18 MHz高频彩色多普勒超声技术对T2DM患者足背血管病变的检查在基层社区医院的应用,有助于更好的预测糖尿病足的发生。
Objective To predict the incidence of diabetic foot in patients with type 2 diabetes mellitus（ T2DM） by examining dorsalis pedis artery with 18 MHz high frequency color Doppler ultrasonography. Methods A total of 188 patients with T2DM who underwent routine physical examination in community hospitals from October 2014 to August 2016 were divided into concurrent diabetic foot group（ n = 59） and non-concurrent diabetic foot group（ n = 129） by the professional doctor according to the specific circumstances of patients. First of all,the general clinical data of patients including gender,age,BMI index,course of diabetes were recorded in detail. Then blood specimens of patients were collected,and the blood glucose levels and inflammatory indexes were detected,including fasting blood glucose（ FPG）,postprandial 2h blood glucose（ 2h-PG）,glycosylated hemoglobin（ HbA1c）,white blood cell count（ WBC） and C-reactive protein（ CPR）. Then dorsalis pedis artery was examined by using 18 MHz high frequency color Doppler ultrasonography,and blood flow（ BF）,arterial diameter（ BD）,intima-media thickness（ IMT）,peak flow rate（ PFV）,end diastolic velocity（ EDV）,mean velocity（ MFV）and pulsatility index（ PI） were detected and compared between two groups. Results There were no significant differences in gender,age,BMI and FPG between two groups,however,there were significant differences in the length of disease course,2h-PG,HbA1c,WBC and c RP between two groups（ P〈0. 05）. The examination results by high frequency ultrasound showed that there were no significant differences in BF,BD,IMT,EDV and MFV between two groups（ P〈0. 05）. However the PSV and PI in concurrent diabetic foot group were significantly lower than those in non-concurrent diabetic foot group（ P〈0. 05）.The correlation analysis showed PSV was negatively correlated with HbA1c（ P〈0. 05）,and PI was negatively correlated with HbA1c,WBC and CRP（ P〈0. 05）. And the ROC curves of PSV and HbA1c were drawn to compare the diagnostic efficacy of predicting the incidence of diabetic foot. The area under curve of PSV was 0. 803,and sensitivity and specificity were 92. 2%,62. 7%,respectively,w ith critical point being 38. 00 cm/s. The area under curve of HbA1c was 0. 621,and sensitivity and specificity was 83. 1 %,40. 3%,respectively,w ith critical point being 6. 93%. Conclusion The application of 1 8 MHz high frequency color Doppler ultrasonography in community hospital helps to predict preferably the incidence of diabetic foot in patients with T2DM.
出处
《河北医药》
CAS
2018年第3期325-328,共4页
Hebei Medical Journal
基金
上海市卫生局科研课题资助(编号:20134138)
关键词
2型糖尿病
足背动脉
血管病变
高频彩色多普勒超声
type 2 diabetes
dorsal artery of foot
vascular lesions
high frequency color Doppler ultrasound
