超声弹性成像技术评价2型糖尿病合并微量白蛋白尿患者颈动脉血管壁弹性变化及其临床意义

摘要

目的 探讨超声弹性成像技术评价2型糖尿病(T2DM)合并微量白蛋白尿(MA)患者颈动脉血管壁弹性变化及其临床意义.方法 将91例T2DM患者根据尿白蛋白排泄率(UAER)分为T2DM未合并MA患者组(49例)和T2DM合并MA患者组(42例),应用超声弹性成像技术测量患者右侧颈总动脉弹性硬度系数比值(B/A值),并对两组B/A值及一般资料进行比较及相关性分析.结果 T2DM合并MA患者组B/A值高于T2DM未合并MA患者组,差异有统计学意义(P＜0.05);两组中B/A值与血肌酐(CREA)、UAER及糖化血红蛋白(HbA1c)之间呈正相关(r= 0.266,P ＜0.05;r=0.426,P ＜0.05;r=0.405,P＜0.05);T2DM合并MA患者组餐后2 h血糖(2 h PG)、体重指数(BMI)、血清总胆固醇(TC)、CREA、UAER、HbA1c高于T2DM未合并MA患者组,差异有统计学意义(P＜0.05).结论 T2DM合并MA患者颈动脉血管壁弹性下降,超声弹性成像技术能够准确、快捷地检测出T2DM合并MA患者颈动脉血管壁弹性的变化,从而指导临床医师给予患者积极的治疗,改善预后.%Objective To evaluate carotid artery wall elasticity and clinical significance m the patients with type 2 diabetes mellitus ( T2DM) complicated with microalbuminuria ( MA) by ultrasonographic elastography. Methods Ninety-one patients with T2DM were divided into two groups according to urinary albumin excretion rate (UAER) : T2DM without MA ( T2DMI group, 49 cases) and T2DM with MA ( T2DM2 group, 42 cases). The ratio B/A ( the ratio of elastic stiffness coefficient) of the right common carotid artery were calculated by ultrasonographic elastography. The correlation between B/A and general data was analyzed. Results Compared with the value in the T2DM1 group, the B/A of T2DM2 group was significantly higher (P＜0. 05). The B/A was correlated with CREA, UAER and HbAlc (r = 0. 266,P ＜0. 05 ; r =0. 426, P ＜0. 05 ; r =0. 405 , P＜0. 05). The 2 h PG, BMI, TC, CREA,UAER and HbAlc of T2DM2 group were significantly higher than those of T2DM1 group (P ＜0. 05). Conclusion The carotid artery wall elasticity in T2DM with MA decreased. Ultrasonographic elastography can accurately and rapidly evaluate carotid artery wall elasticity in T2DM with MA, which can guide clinical physician with aggressive treatment and prognosis of improvement.