| Objective:To investigate the value of color Doppler ultrasound in detecting early atherosclerosis (carotid MT) and the hemodynamic changes of carotid artery in hypertension patients and diabetes-hypertension patients.Methods:159 people including the normal control group, hypertension patients and diabetes-hypertension patients were assessed by means of high-frequency color Doppler imaging to collect the vascular diameter, the intima-media thickness and plaque condition of common carotid artery, internal carotid artery, external carotid artery and carotid bifurcation and biochemical tests data and analyze the hemodynamic changes on peak systolic velocity (SPV), end-diastolic velocity (EDV) and resistance index (RI) with color Doppler. All patients were divided into three groups:the hypertension patients group, diabetes-hypertension group and the normal group to compare the atherosclerotic situation of three groups and perform statistical analysis.Results:1.2D Doppler image feature1.1 The normal carotid wall represented the typical three-layer echo:the intima middling echo, adventitia strong echo, media low or middling echo. The normal value is CCAIMT＜1.0mm, BIFIMT＜1.2mm.1.2 There were 19 cases 22 vessels with intima incrassation occurrence among the 91 hypertension patients. There were 34 cases 60 vessels with intima incrassation occurrence and plaque formation. The incidence of intima incrassation and plaque formation in the hypertension group was greater than the normal group significantly.1.3 There were 9 cases 11 vessels with intima incrassation occurrence among the 37 diabetes-hypertension patients. There were 19 cases 25 vessels with plaque formation. The incidence of intima incrassation and plaque formation was greater than the normal group. The IMT of CCA, ECA and ICA of diabetes-hypertension group was significantly different from the normal group, with more noteworthy BIFIMT.2. Color Doppler flow image detection2.1 The normal carotid artery is filled in abundant bloodstream. The color in vessel center is brighter than near wall. The turbulent flow can be seen at carotid bifurcation.The laminar flow can be seen at the other position of the vessel.2.2 The bloodstream can not be seen in position of intima incrassation occurrence and plaque formation in the hypertension group and diabetes-hypertension group.3. Pulse wave Doppler3.1 The spectrum of ECA is with high resistance index, while CCA and ICA are with low resistance index in the normal group. The resistance index:ECA>CCA>ICA.3.2 The resistance index of CCA, ICA and ECA in hypertension group and diabetes-hypertension group is greater than normal group significantly. In this study, the occurrence of atherosclerotic plaques on carotid arteries does not lead to obvious vessel stenosis. So the velocity does not increase markedly.4. Intima incrassation often occurred at the bifurcations of the common carotid, the common carotid and the beginning of the internal carotid artery. Besides intima incrassation, endarterium echo also enhanced and discontinuity takes place in early atherosclerosis in part arteries. Diffuse vessel wall incrassation occurs in CCA with few plaque formations.5. Atherosclerotic plaque is mainly hard and soft plaque, with the ratio of 31.96% and 31.96% respectively, followed by mixed plaque with the ratio of about 25.77%. Flat plaques are rare, accounting for 10.31% plaque ratio.6. In early atherosclerosis, CCA, ICA, ECA's diameter in hypertension group and diabetes-hypertension group was significantly greater than the normal group.7. The study also combined with ophthalmic artery and cardiac ultrasound examination. Atherosclerosis showed aortic wall echo increased, the range of motion reduced (≤8mm) and re-pump wave disappeared. Atherosclerosis results in tortuous retinal vessels and increased reflection.Conclusions:1. IMT thickening is the early indications of atherosclerosis; plaque formation is the typical signs. IMT and plaque are of predictive value for atherosclerosis. They can be used as the important indicators to predict atherosclerosis.2. Carotid artery ultrasound assessment can establish the early diagnosis of arteriosclerosis, control intima-medial thickening, plaque morphology, size, echo, volume and location and provide hemodynamic changes to provide an important basis for the clinical. Therefore, color Doppler ultrasound detecting carotid artery can be used as a "window" to estimate systemic atherosclerosis. It is of great value on the early detection of cardiovascular disease.
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