微创医学

目的探讨彩色多普勒超声在诊断2型糖尿病患者颈动脉粥样硬化性病变中的临床价值。方法将131例2型糖尿病患者按微量尿白蛋白水平分为阳性组（70例）和阴性组（61例）。采用彩色多普勒超声比较两组患者的颈动脉内-中膜厚度（IMT）、动脉斑块及狭窄等情况。结果阳性组颈动脉IMT为（1.20±0.33）mm，明显高于阴性组的（0.97±0.24）mm；阳性组颈动脉粥样硬化斑块发生率为左侧38.6%（27/70）、右侧42.9%（30/70）、双侧30.0% （21/70），阴性组颈动脉粥样硬化斑块发生率为左侧19.6%（12/61）、右侧21.3%（13/61）、双侧14.8%（9/61）；阳性组颈动脉狭窄发生率为左侧20.0%（14/70）、右侧21.4%（15/70）、双侧15.7%（11/70），阴性组颈动脉狭窄发生率为左侧14.8%（9/61）、右侧13.1%（8/61）、双侧11.5%（7/61），阳性组明显高于阴性组（P＜0.05）；阳性组24 h尿蛋白排泄率（UAE）为（86.4±52.2）mg/d，明显高于阴性组的（15.4±6.8）mg/d，两组比较，差异有统计学意义（P＜0.05）。阳性组患者颈动脉IMT厚度与UAE呈正相关（r=0.28，P＜0.05）。结论彩色多普勒超声可作为颈动脉粥样硬化和狭窄的诊断手段，对于UAE显著增高患者，颈动脉斑块形成风险显著增加。

ObjectiveTo explore the diagnosis value of color doppler ultrasonograph on carotid atherosclerosis of patients with type 2 diabetes mellitus. MethodsA total of 131 patients with type 2 diabetes mellitus were divided into positive group(70 cases) and negative group(61 cases) according to the level of microalbuminuria. Color doppler ultrasound was used to detect the carotid artery middle thickness (IMT), artery plaque and stenosis of the two groups. ResultsCarotid artery IMT of positive group was (1.20±0.33) mm, significantly higher than (0.97±0.24) mm of the negative group(P＜0.05). The incidence rate of carotid atherosclerotic plaque in the positive group was (left 38.6%,right 42.9%,both side 30.0%) much higher than those in the negative group(left 19.6%,right 21.3%,both side 14.8%)group(P＜0.05); The incidence rate of stenosis in the positive group was (left 20.0%,right 21.4%,both side 15.7%) much higher than those in the negative group (left 14.8%,right 13.1%,both side 11.5%) group (P＜0.05). And the UAE level of the positive group was(86.4±52.2)mg/d much higher than（15.4±6.8）mg/d of the negative group (P＜0.05). The UAE level was significantly correlated with IMT in the positive group(r=0.28, P＜0.05). ConclusionColor Doppler ultrasound can be used as an effective diagnostic tool for carotid atherosclerosis and stenosis; The risk of carotid plaque formation was significantly increased in patients with higher UAE.