Study On Carotid Atherosclerosis In Type 2 Diabetes Mellitus With Ultrasonic Intergrated Backscatter Technique

Diabetes Mellitus(DM) is a metabolism abnormality syndrome and it is resulted from the interaction between heredity and environment. The chronic hyperglycemia is main characteristic of DM. Recently, incidence of DM increase gradually. Type 2 Diabetes Mellitus is main type of DM. Long- term type 2 DM can lead great vessels complication, the pathology change of it is artherosclerosis(AS). Coronary arteriosclerotic heart disease and cerebral infarction by AS is the main cause of mutilation and death of type 2 DM. In the patients of type 2 DM, How to diagnose AS early , and how to evaluate its degree and relation between artherosclerosis and cerebrovascular and cardiovascular complication are important for the prevention and the treatment of type 2 DM.Recently, ultrasound technique is generally used in examining AS. It not only can reflect level of vessel narrow, also reflect condition of arterial wall, and conduce to discovery AS in early stage. 2D-Ultrasound technique can examine the thickness of intima-media tunica (IMT) and the mode of plaque and the level of vessel narrow in artery. Reliability of diagnosing AS according to measuring IMT by Ultrasound technique has be proved in clinic. IBS was a important method to distinguish different tissue. It reflection sonics chang of tissue has good correlation with change of tissue ingredient. It can reflect micro-change of biological tissue structure quantitately, and has diagnosis value for judging changes of physiology and pathology in tissue. In this study, the IMT and IBS value of carotid artery and plaques of patients in type 2 Diabetes Mellitus had been examed by the method of 2D-ultrasonic and IBS. The correlation between artherosclerosis and clinical situation and course of disease in type 2 DM had been analysed. The purpose was how to early discovery AS in type 2 DM use ultrasound method and study correlation between the degree of AS and course and complication. That can provide some new quantitative parameter for early diagnosis artherosclerosis in type 2DM and the risk of cerebrovascular and cardiovascular complication and instructe treatment in clinic.117 clinic reseach objects had been divided to three groups : normal youth group(A group) ,30 cases, 20-30 years normal youth; normal control(B group),30 cases, normal adults of age more than 30 yesrs; A group and B group haven't hypertension and diabetes and hyperlipemia and renal disease and coronary arteriosclerotic heart disease and hepatopathy. There are no abnormalities in medical examination and laboratory examination in A group and B group. Type 2 DM group (C group) ,57 partients in type 2 DM. Also C group were divided different groups by complication and course meanwhile. In the reseach objecs, CCA,ICA,ECA had been examined using HP SONOS-5500 ultrasonograph and examined indexes include IMT of arteries and IBS of arteries and plaques. The values of indexes had been statistic analysis.The results showed: 1.2D-ultrasonic of carotid arteries:â‘ IMT: A group < B group < C group,there is significant deviation in the carotid arteries IMT of between A,B,C groups, and. The IMT of complication groups is thicker than no-complication group in C group and there is significance differences between 2 groups. The IMT of group of course > 10years is thicker than group of course <5years in C group and there is significance differences between 2 groups.â‘¡The detection rate of carotid plaque:C group is higer than B group;complication group is higer than no-complication group in C group; The group of course > 10years is higer than group of course <5years. Plaques were divided into soft plaque and fibrous plaque and calcified plaque and complex plaque on the basis of 2D-Ultrasound characteristic.The majority of plaque in complication group is soft and complex plaques while that in B group and no-complication group of C group is calcified plaques. 2. IBS of Endarterium and plaque:â‘ IBS value of Carotid intima of B group is significant higher than of A group and significant lower than of C group. IBS value of Carotid intima of no-complication group in C group is significant higher than of complication group in C group and significant lower than of B group and slight higher than of A group. IBS value of Carotid plaque of B group is significant higher than of C group, and that of course <5years group is significant lower than course>10years group.â‘¡The comparing IBS values: AII value is of calcify plaque>of fibrous plaque>of fatty plaque and there is significance differences; PPI value and SDI value of complex plaque are significant higher than of other type plaques. 3.IBS and IBSc%: there is coincidence relation between 2 values in every groups. The difference of IBS value between every groups is more obvious than of IBSc%value .This research indicated:1. DM can induce and aggravate AS.â‘ Under the same background of age ,the carotis IMT is more thick and IBS value is lower in type 2 DM than in health adult, this is ultrasonic appearance of AS in type 2 DM. In patients of type 2 DM, because insulin resistance and high insulinemia effect, the fatty synthesis of vascular smooth muscle cell and collagenoblast increase. At the same time multiple factor ,such as fatty metabolic disorder and proteinum non-biocatalyst glycosylation and vascular endothelial cell and so on, cause arterial wall catch fatty .Then the fatty aggregate in vessel wall, it encourage the IMT thickening and the intima fatty content increase .â‘¡The detection rate of arital plaques in type 2 DM group was significantly high. This indicated that Artherosclerosis in type 2 DM patients happen in early stage and seriously. Instability plaque(fatty plaque and complex plaque ) has high detection rate in patients with complication in type 2 DM patients.2. The IMT increase and IBS value degrade in type 2 DM more obviously when it has complication. It indicated the level of AS aggravate. Therefore ,it has sense for judge risk of compication to measure artery IMT and IBS value in type 2 DM patients. The PPI value and the SDI value in IBS technique has important sense to judge complex plaque, and complex plaque is instability plaque with high danger.3. Along with the course lengthening , the change of IMT increasing and IBS value degrading more obviously. This indicated :Along with the course to lengthen , the level of AS aggravate gradually.4. The IBS techinque can shows changes of tiuess composition of arterial wall and character of atheromatous plaque , it offer a fixed quantity diacrisis method for AS in type 2 DM patients. Integrated backscatter can evaluate the composition of carotid plaque structures. It possesses diagnosis value for judge character of plaque and risk of artherosclerosis and cerebrovascular; The IBS technique can provide an important method evaluating As in type 2 DM patients objectively. This method will play a significant role in course of dignosing and treating in type 2 DM.