| Diabetes mellitus (DM) is a metabolic disordered disease characterized chronicity hyperglycaemia caused by many etiological factors. It can be divided into secondary and primarily kind that takes the majority and has genetic predisposition. Its basic pathology and physiology is metabolic disorder caused by absolute or correspondent hypoinsulinism and the increase of GLA. According to the report of WHO, worldwide incidence rate of DM has a manifest upgrading tendency. DM has become one of principal diseases harmful to people's health. Its pathological change-artherosclerosis, is similar with vascular lesion pathological change of patients who don't have DM. Extremity peripheral vascular lesion majored with arteries of lower extremity affection, which appeared as inferior extremity pain, cacesthesia, angiosclerotic myasthenia, severe insufficiency of blood-supply and extremity gangrene. The early researches always used hypersound to detect arteria carotis to comprehend the condition of DM artherosclerosis. In this thesis, we choose color Doppler ultrasound to detect the form condition of DM patients'arteria carotis, arteria cruralis, IMT of distal end arterial and plaque and to comprehend the developing features of DM artherosclerosis with the aim of discovering DM patients'change of haemodynamics, morphous and architecture of peripheral blood vessel in the earlier course of disease to provide directed significance of DM therapeutic regimen. Materials and Methods:1 Objectivesin hospital patients during the April of 2005 and the February of 2007; healthy volunteers are the people attending health examination in medical examination center of our hospital.1.1 Group A42 cases.ⅡDM patients (23 males, 19 females), 32 to 69 years old. The average age is 52.1±12.8. The course of disease ranges from 4 months to 22 years.1.2 Group B30 cases. HBP and HL patients (16 males, 14 females), 36-67 years old. The average age is 53.3±11.2. The courses of disease range from 6 months to 25 years.1.3 Group C30 persons. Healthy control group (17 males, 13 females), 33 to 65 years old. The average age is 50.2±11.6.2 Equipments and methods:2.1 equipmentsLOGIQ7 color Doppler diasonography by GE, linear array feeler with frequency of 5-13 MHz, arterial blood vessel, sampling volume 3-5mm, placed in the middle of longitudinal section of blood vessel, included angle of acoustic velocity and blood current is less than 60.2.2 detection methods2.2.1 Carotid detection2D hypersound: observation of double sides'arteria carotis communis, furcation, outer segmental cranium arteria carotis interna and tubal wall echo of outer segmental cranium arteria carotis externa. Measurement of endomembrane-intercellular layer thickness (IMT) of blood vessel paries posterior at 1cm of arteria carotis bifurcate proximal end. Record of plaques'quantity, location,size and echo intensity in arteria carotis. Color Doppler ultrasound: Observations of color engorge condition of blood current striation inarteries. Pulse Doppler ultrasound: observation of blood current spectra condition, measurement of haemodynamics parameters: Vmax,PI,RI. Transsection then longitudinally cut to get the general average of three measurements.2.2.2 Detection of arteries of lower extremity2D hypersound: observation of double sides arteria cruralis, ham arteries, tubal wall echo, shapes of arteria tibialis posterior and arteria dorsalis pedis. Measurement of IMT. Record of plaques'quantity, location, size and echo intensity. Color Doppler ultrasound: observation of color engorge condition of blood current striationinarteries. Pulse Doppler ultrasound: observation of blood current spectra condition, measurement of haemodynamics parameters: Vmax,PI,RI. Transsection then longitudinally cut to get the general average of three measurements.Results and discussion1 The arteria carotis and arteria cruralis IMT in group A and B are obviously thicker than group C (P<0.01). The thickening rate of arteria cruralis IMT of group A is higher than group B (P<0.05). IMT thickening is a sign of the earlier period change of arteries wall. Endomembrane intercellular layer thickness abnormal rising segments'danger of appearing plagues obviously upgrades. According to this research's result, DM, HBP and hyperlipemia are dangerous factors leading to artherosclerosis. DM patients'arteries of lower extremity are frequently involved in and their arteria cruralis IMT thickening rate is higher than arteria carotis. Therefore, detection of DM patients'arteria cruralis IMT is significantly meaningful to the anticipation of atherosclerotic of DM.2 The incidence rate of arteria carotis and arteries of lower extremities'atherosclerotic plaque of group A and B increased obviously (P<0.01); the detection rate of arteria cruralis plaque of group A is obviously higher than group B (P<0.01); lumens angusty rate is frequently seen on the distal end arterial blood vessel under ham arteries (P<0.05). Plague is manifest feature of artherosclerosis, can reflect the degree of artherosclerosis. Nowadays researches of periphery artherosclerosis always use hypersound sign of arteria carotis scleratheroma. The thickening of carotid wall is the early period sign of artherosclerosis. The results of this study show that detection rate of arteria cruralis plague is higher than that of arteria carotis plague of DM patients and angiostegnosis always appears in the arteries below knees. So DM artherosclerosis mostly appears in arteries of lower extremity, especially in the arteries below knees.3 There is no significant difference of AS plaques'incidence rate between group A and B (P>0.05). Atherosclerotic plaques'sonographic appearances of DM, HBP and HL patients'are almost same, which are applan macula, blet, pachy macula and intermix macula. The two groups'incidence rates of these kinds of plaques are almost same.4 color Doppler ultrasound detectionNormal arteries 2D topography should be endangium is velvet and humble, having good succession, front and behind of tubal wall as duplicate bands horizontal echo zone after longitudinally cut; cross section is round and having impulsivity. CDFI features, vessel wall and color blood current have distinct terminal line. During the period of contraction, the center of blood vessel is high speed blood vessel with bright color; the one near to bilateralis tubal wall is brachytely blood vessel with dark color, blood current having no obvious filling defection and blood color in arteries appearing the quick change of red-blue-red in a cardiac cycle. Normal arteries of lower extremity's pulse Doppler frequency appearance is three-phase blood current frequency spectrum, frequency band is narrow, and there is a"window"without blood current signal between frequency band and basal line.Artherosclerosis 2D topography features are tubal wall echo enhancement, IMT thickening in different degrees, unsmooth endomembrane, formation of unequal size atherosclerotic plaque, predominance into the lumens. CDFI borderline of blood current is irregular, blood striation thinningz, plaque position appears color filling defection, stricture section appears color mosaicism blood current, color blood current change into rarefact and gloom at the position of brady flow rate, and there is no blood current signal at the position of vascular occlusion.Artherosclerosis of arteries of lower extremity makes the time of blood flow rate reaching apogee relatively extend, upgrading speed of frequency spectrum slow, construction hump of frequency spectrum change into round and blunt, frequency band widen, frequency window diminish. It appears hyp- width succession, monophase blood current frequency spectrum; backward blood current disappears during the period of relaxation.Conclusion1,The detection of arteria cruralis IMT of DM patients'is very important to early diagnosis of DM artherosclerosis.2,Artherosclerosis of arteries of lower extremity is always seen in the distal end arterial blood current of ham artery.3,There is no significant difference of DM, HBP and HL atherosclerotic plaques'sonographic appearances.4,Color Doppler ultrasound is accurate and convenient in the detection of DM patients'periphery artherosclerosis and can make repeated detection.
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