| Objective: The pulse wave velocity of carotid artery in type 2 diabetic patients was detected by ultrafast pulse wave velocity(UFPWV)to explore the value of this technique in the evaluation of carotid artery elasticity quantitatively in type 2 diabetic patients.Methods: Sixty patients with type 2 diabetes who were hospitalized in department of endocrinology of our hospital from February 2017 to October 2017 and underwent carotid routine ultrasound examination at the department of ultrasound were selected as the case group of this experiment And diabetes diagnosis refer to 1999 WHO standard.According to the carotid intima-medium thickness and whether accompanied by plaque formation were divided into three groups: A group(IMT normal group): type 2 diabetes carotid intima-medium thickness(IMT)<1.0mm(20 cases,11 males and 9 females,aged 41-59 years,mean age 50.20 ± 5.21 years);group B(IMT thickening group): type 2 diabetic patients 1.5mm> IMT≥1.0mm(20 cases,10 males and 10 females,aged 40-58 years,mean age 49.75 ± 5.09 years);group C(carotid plaque group): carotid artery plaque in type 2 diabetic patients thickness ≥1.5mm(20 cases,10 males and 10 females,aged 45-59 years,mean age 50.85 ± 3.76 years);another 30 healthy volunteers as the normal control group(D group,male 14 cases,female 16 cases,aged 40-59 years,mean age 50.00 ± 5.41 years).Equipment:The Color Doppler Ultrasound Diagnostic Instrument of Supersonic Imagine Aixplorer manufactured by French Acoustics Company is used,and the SL10-2 linear array probe is also provided with the frequency between 2 and 10 MHz.Select Vascular conditions,built-in ultrafast pulse wave velocity technology.Procedure:(1)IMT measurement: Subjects in supine position,in a quiet and steady state of breathing,fully exposed bilateral neck,head biased to the contralateral,first cross-section and then longitudinal section scanning bilateral common carotid artery,to be clearly visible neck The IMT was frozen and the IMT was recorded within 1.0 ~ 1.5cm below the bifurcation level of the common carotid artery.The size of the plaque was recorded.According to IMT and plaque diagnostic criteria for《Vascular and Superficial Ultrasound Procedures》,carotid IMT was defined as IMT ≥ 1.0 mm and plaque was defined as ≥ 1.5 mm.(2)PWV measurement: the probe placed in the proximal carotid artery bifurcation 1 ~ 2cm at the position parallel to the long axis of the common carotid artery maximum section,to be clearly displayed in the carotid artery before and after the wall of the intima-medium thickness Click the "PWV" key during the data acquisition(2s)to keep the probe stable,ask the patient to remain stationary,the process of the probe can not do any movement,After the image processing is started,the probe can leave the patient.If the blood vessels was collected is not satisfactory,the blood vessel segments can be selected by changing the size and position of the sampling frame,but the sampling frame is as big as possible and can contain more information.Including the vessel wall,click the "Select" button on the control panel to display the speed-time color map of the anterior wall movement.The system also calculates automatically and displays PWVBS(pulse wave velocity at the beginning of systole)and PWVES(pulse wave velocity at the ending of systole),The corresponding standard deviation should control the BS or ES value of less than 10% as much as possible,the largest no more than 20% indicates a good stability of the data is collected.Image selection and data measurement to ensure that there are one or two doctors with the experience of blood vessels ultrasound.Each subject repeated measurement 3 times,take the average for statistical analysis.Results:1.the left carotid artery PWVBS,PWVES value slightly higher than the right in IMT normal group,IMT thickening group,carotid plaque group in patients with type 2 diabetes as well as the normal control group,but the difference was not significant(p> 0.05);2.The carotid PWVBS and PWVES in carotid IMT thickening group were slightly higher than those in IMT normal group in type 2 diabetes mellitus,but the difference was not significant(p> 0.05);3.Carotid plaque group carotid PWVBS and PWVES were higher than those in IMT normal group and IMT thickening group in type 2 diabetic patients,the difference was significant(p <0.05);4.The PWVBS and PWVES values of IMT normal group,IMT thickening group and carotid plaque group in type 2 diabetes mellitus group were higher than those in normal control group,the difference was significant(p <0.05).Conclusion:1.The PWVBS and PWVES values of the carotid arteries of patients with type 2 diabetes mellitus were significantly higher than those of the normal control group,indicating that arterial elasticity of type 2 diabetes patients was lower than that of normal people;2.As CA increases the degree of hardening,the more severe the impairment of elasticity;3.Carotid artery changes in arterial elasticity have occurred prior to morphological changes(IMT ≥ 1.0mm)in patients with type 2 diabetes;4.UFPWV can make a diagnosis before the carotid artery morphological changes of type 2 diabetes mellitus patients so as to achieve the purpose of early prevention,early diagnosis and early treatment of carotid atherosclerosis in type 2 diabetic patients. |
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