【作者】 程盼；

【导师】 吴荣秀；

【作者基本信息】 天津医科大学 ， 影像医学与核医学， 2011， 硕士

【摘要】 目的：探讨2型糖尿病(DM)患者下肢动脉内-中膜厚度(IMT)与血流剪切率(SR)及相关危险因素之间的关联性及其意义。为DM患者治疗及早期预防提供新的思路和理论依据。方法：随机研究已经确诊为2型糖尿病108例患者,超声观察下分为病变组(内膜增厚组)67例及非病变组(内膜正常范围组)41例,并同期观察正常对照组57例,用彩色多普勒超声(CDFI)检查下肢动脉血管,观察双下肢股总动脉股浅动脉、胭动脉、胫前动脉、胫后动脉、足背动脉,逐条纪录各动脉内中膜厚度、管径(D)及收缩期峰值流速(PSV),于后期计算SR；观察斑块情况；彩色多普勒及频谱多普勒超声观察动脉血管内彩色血流充盈情况及频谱形态；同时抽取空腹静脉血测定相关生化指标并对每个受试者进行详细体格检查。将3组数据分别进行比较,分析其与糖尿病下肢动脉病变的关系。结果：1.DM组与对照组相比SR均降低,有明显差异(P<0.05)；2.DM下肢动脉病变有关的危险因素包括：病程、年龄、空腹血糖、2小时餐后血糖、糖化血红蛋白、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、全血黏度高切、纤维蛋白原、收缩压及腰围(P<0.05)；3.代谢综合征(MS)与DM下肢动脉病变关系密切。结论：1.2型糖尿病患者在出现IMT增厚之前已有SR的降低,SR是动脉粥样硬化的重要形成因素；2.2型糖尿病下肢动脉病变与MS的多种危险因素密切相关,互为因果,应引起足够重视,汁意早期预防。更多还原

【Abstract】 Objective:To investigate the relevance between intima-media thickness (IMT) of the lower peripheral arteries, shear rate (SR) and related factors in TypeⅡdiabetic patients. And propose new standpoint and theoretical foundation to diabetic patients for the prevention and therapy.Methods:A total of 108 random TypeⅡdiabetic patients and 57 control groups were recruited for the investigation. The TypeⅡdiabetic patients were divided into two groups:67 patients with thickening Intima and 41 patients with normal Intima. Following factors will be observed at the same time:common femoral artery, superficial femoral artery, popliteal artery, arterial tibial anterior, posterior tibial artery and dorsal pedis artery of double legs with all patients. The intima-media thickness, diameter (D) and PSV (Peak Systole Velocity) of the lower peripheral arteries were measured with CDFI (Color Doppler Flow Imaging), and this data will be used to calculate SR (Shear Rate)-. Meanwhile, observe the condition of plaques, color flow and spectrum shape. Analyze the relationship of lower peripheral arteries judged by Doppler ultrasonic, biochemical parameters and detailed physical examination of the three groups that were used for this investigation.Results:1. In diabetes patients groups, the SR was lower than that are in control group (P＜0.05).2.The risk factors related to the lower peripheral arteries of diabetic patients included years of disease, ages, the fasting plasma glucose,2hour-fasting blood glucose,HbAlc, total cholesterol, triglyceride. high density lipoprotein, low density lipoprotein, whole blood viscosity at high shear rate, fibrinogen, systolic blood pressure, and waist (P＜0.05).3. There is a close relation between MS (Metabolic Syndrome) and lower peripheral arteries of diabetic patients. Conclusion:1. The decrease of SR in diabetes patients can be found before the IMT thicker, and it is one of the important factors that lead to atherosclerosis.2.The lower peripheral arteries of diabetic patient was related to various risk factors of metabolic syndrome, should be early prevented and paid more attention.更多还原