2型糖尿病下肢血管病变彩超检测临床分析.DOCVIP

临床医学论文-2型糖尿病下肢血管病变彩超检测临床分析 【关键词】? 下肢血管病变；糖尿病；彩色多普勒超声检查 　　［摘要］? 目的? 探讨2型糖尿病下肢血管病变相关因素及其与并发症关系。方法? 对76例2型糖尿病人进行血糖、血脂、血液流变学检测，同时应用彩超检测双下肢动脉内膜增厚、管腔狭窄、斑块形成的部位与类型、血流频谱。结果? 发生下肢血管病变者52例（68.42%），其并发症主要有高血压、周围神经病变、糖尿病足，与对照组比较P0.05；影响因素主要有高血压、餐后高血糖、HDL-C低，与对照组比较P0.01；彩超显示，双下肢动脉粥样硬化高达83%，左侧软斑高于右侧。结论? 2型糖尿病下肢血管病变与高血压、餐后高血糖、血脂异常相关，彩超可早期发现血管病变，指导及时治疗，降低截肢率。??? 　　［关键词］? 下肢血管病变；糖尿病；彩色多普勒超声检查?? 　　Clinical analysis of lower-extremity arterial disease? in type 2 diabetic mellitus by color Doppler ultrasound 　　［Abstract］? Objective? To explore the correlated factors of lower-extremities arterial disease（LEAD） in type 2 diabetic mellitus（DM）and the relationship with complications.Methods? Of 76 cases of DM,blood glucose,lipidemia,hemodynamics were analyzed,and lower extremities artery stenosis,atherosclerosis plaque were detected by use of color Doppler ultrasound.Results? The study showed that 52 cases had LEAD,which was closely related to hypertension,peripheral neuropathy disease（PND）,diabetic foot.It was significantly higher than the control（P0.05）.The major affecting factors were hypertension,postprandial hyperglycemia,low level of high density lipoprotein（HDL）,which were significant（HDL）（P0.01）.It also showed that lower extremities atherosclerosis was as high as 83%,and the AS plaque in left was higher than in right.Conclusion?LEAD in type 2 DM is correlated with hypertension,postprandial hyperglycemia,abnormal lipidemia.The color Doppler ultrasound can find the early vascular lesions to guide the treatment and decrease the rate of amputation. 　　［Key words］? lower extremities vascular lesions;diabetic mellitus;color Doppler ultrasonography 　　糖尿病下肢血管病变（LEAD）又称周围血管病变（PVD），是导致下肢截肢，特别是高位截肢和再次截肢的主要原因，其发病率较非糖尿病患者高20倍。80%病人在诊断糖尿病时已存在LEAD，并随年龄、病程的增加而增多［1］。早期缺乏典型临床表现，为了早期诊断下肢血管病变，我院对已确诊的76例2型糖尿病患者进行了下肢动脉血管超声检查。现将结果分析如下。 　　1? 资料与方法 　　1.1? 一般资料? 我院内分泌科近1年住院的2型糖尿病患者共76例，均符合1999年WHO糖尿病诊断与分型标准。男36例，女40例；年龄41~70岁，平均62.5岁；病程3个月~20年，平均7.02年。其中合并高血压病35例，冠心病13例，脑血管病5例，糖尿病足6例，周围神经病变17例，视网膜病变11例，