【作者】 郭佩琦；

【导师】 王学梅；

【作者基本信息】 中国医科大学 ， 影像医学与核医学， 2009， 硕士

【摘要】 目的运用E-Tracking技术检测糖尿病视网膜病变患者的颈动脉弹性,并检测其视网膜中央动脉(CRA)的血流动力学参数,旨在探讨其在检测早期糖尿病血管病变的临床价值。材料与方法本研究采用ALOKAα—10彩超诊断仪,选择2型糖尿病患者90例及健康志愿者30例。患者取仰卧位,获取颈总动脉长轴切面,常规测量颈动脉收缩期内径(Ds)、血管内膜中层厚度(IMT)、收缩期峰值流速(PSV)、阻力指数(RI),进入E-Tracking模式,自动计算出血管内径的变化,得出压力-应变弹性系数(Ep)、硬化参数(β)、顺应性(AC)、单点脉搏波传导速度(PWVβ)、增大指数(AI)。测量双眼视网膜中央动脉,观察收缩期血流峰值速度(Vs),舒张末期血流速度(Vd)和阻力指数(RI)。统计学分析:全部资料应用SPSS11.5进行统计分析和作图。所有计量资料均以均数±标准差表示。组间均数比较采用非配对t检验。两参数之间相关性采用相关分析。检验标准以P＜0.05认为具有统计学意义。结果1.与对照组比较,糖尿病A组、B组、C组Ds、PSV、RI无明显差异,糖尿病A组IMT无显著性差异;糖尿病B组IMT有显著性差异(P＜0.05);糖尿病C组IMT有显著性差异(P＜0.01)。2.与对照组比较,糖尿病A组Ep、β测值均明显高于对照组(P＜0.01),PWVβ、AI高于对照组(P＜0.05);AC测值低于对照组(P＜0.05)。糖尿病各组间Ep、β、PWVβ、AC测值有统计学差异(P＜0.05),AI无统计学差异。3.与对照组比较,糖尿病A组Vs、Vd明显低于对照组(P＜0.01),RI明显高于对照组(P＜0.01)。糖尿病各组间Vs、Vd、RI有统计学差异(P＜0.05)。4.糖尿病组视网膜中央动脉血流参数Vs、Vd与颈动脉弹性参数Ep、β、PWVβ、AI呈负相关,与AC呈正相关;糖尿病组视网膜中央动脉血流参数RI与颈动脉弹性参数Ep、β、PWVβ、AI呈正相关,与AC呈负相关。结论2型糖尿病患者颈动脉在发生动脉硬化形态学改变之前,其血管内皮功能即已存在损伤,糖尿病视网膜病变患者颈动脉弹性减低更为明显。糖尿病组视网膜中央动脉血流参数Vs、Vd、RI与颈动脉弹性参数Ep、β、PWVβ、AI、AC明显相关。更多还原

【Abstract】 ObjectiveThe study is to detect carotid elasticity in patients with diabetic retinopathy by E-Tracking technique,and to detect the haemodynamic parameter of the central retinal artery(CRA),in order to evaluate its clinical value in detecting diabetic vasculopathy in early time.Materials and methods90 patients with typeⅡdiabetes and 30 healthy volunteers underwent ultrasonography(US) examination(ALOKAα—10).All US examination were performed with the patients in supine position,and to survery the systolic diameter of the carotid artery(Ds),Intima media thickness(IMT),peak systolic velocity(PSV),Resistanceindex (RI) in long axis view of carotid artery,Then entered the E-Tracking mode,calculated the variation of internal vascular diameter,obtained the pressure strain elastic modulus(Ep),stiffness parameter(β),arterial compliance(AC),pulse wave conducting velocity(PWVβ),augmentation index(AI).Measured the peak systolic velocity(Vs),the end diastolic velocity(Vd) and resistanceindex(RI) of central retinal artery in both eyes.Statistical analysis:Statistical analyses was performed with SPSS11.5 software system.All data were expressed as mean±SD.When compared means among many groups we adopted t-test with post hoc comparison.Pearson’s correlation analysis were performed to display certain relations.Findings with a P value less than 0.05 was considered as statistically significant.Results1.Comparing with the control group,the Ds,PSV,RI have no obvious difference among the group A,B,C.Group A IMT have no obvious difference;Group B IMT have obvious difference(P＜0.05);Group C IMT have obvious difference(P＜0.01).2.Comparing with the control group,Ep,βof group A is higher than the control group(P＜0.01),PWVβ,AI is higher than the control group(P＜0.05);AC is lower than the control group(P＜0.05).The Ep,β,PWVβ,AC among every diabetic groups have statistic difference(P＜0.05),AI has no statistic difference.3.Comparing with the control group,group A Vs,Vd is obvious lower than the control group(P＜0.01),the RI is higher than the control group obviously(P＜0.01).The Vs,Vd,RI have statistic difference(P＜0.05) among every diabetic group.4.The haemodynamic parameter Vs,Vd of the central retinal artery(CRA) in diabetes group are negative correlated with Ep,β,PWVβ,AI,and positive correlated with AC;The haemodynamic parameter RI of the central retinal artery(CRA) in diabetes group are positive correlated with Ep,β,PWVβ,AI,and negative correlated with AC.ConclusionIn patients with typeⅡdiabetes,before the morphology changes in sclerotic carotid artery are observed,the damage of endothelium function already exists.The elasticity of carotid artery in patients with diabetic retinopathy is more lower obviously.The Vs,Vd and RI of central retinal artery are obviously correlated with Ep,β,PWVβ,AI,AC of carotid artery.更多还原