Objective: To evaluate the foot microcirculation in type 2 diabetes mellitus and impaired glucose tolerance patients using contrast-enhanced ultrasound. Methods: Contrast-enhanced ultrasound (CEUS) was performed for examining the blood flow of right foot great toe (TIC) in 56 patients with type 2 diabetes mellitus but without diabetic foot (DM group), 15 patients with impaired glucose tolerance (IGT group) and 12 male control subjects(control group). DM group was divided into two groups according to the course of DM: DM(A) group with course <10 years and DM(B) group with course≥10 years. All the subjects were elderly male patients. Perfusion characteristics of CEUS and parameters of TIC were analyzed. Results: Compared with control group, CEUS image showed lower microvascular density and pale in appearance in IGT, DM and DM(B) groups. Peak intensity (PI) and area under time-intensity curve (AUC) in IGT, DM(A) and DM(B) groups were significantly reduced (P<0.05); PI and AUC of DM(B) group were lower than those of IGT and DM(A) group (P<0.05); and no significant differences in PI and AUC were found between IGT and DM(A) group (P>0.05). The arrival times (AT) and time to peak (TTP) tended to be increased with the extension of DM course, but the difference was not statistically significant (P>0.05). Conclusions: Contrast-enhanced ultrasound can detect the change in foot microcirculation of DM and IGT patients before diabetic foot occurres.
JI Ri, ZHOU Chun, ZHAN Weiwei, YANG Zhifang, GUO Wenjia
. Evaluation of foot microcirculation by contrast-enhanced ultrasound in elderly male type 2 DM and IGT patients[J]. Journal of Diagnostics Concepts & Practice, 2017
, 16(03)
: 287
-291
.
DOI: 10.16150/j.1671-2870.2017.03.011
[1] 徐瑜, 毕宇芳, 王卫庆, 等. 中国成人糖尿病流行与控制现状——2010年中国慢病监测暨糖尿病专题调查报告解读[J]. 中国内分泌代谢杂志,2014,30(3):184-186.
[2] Jiang Y, Wang X, Xia L, et al.A cohort study of diabetic patients and diabetic foot ulceration patients in China[J]. Wound Repair Regen,2015,23(2):222-230.
[3] Ando T, Okada S, Niijima Y, et al.Impaired glucose tolerance, but not impaired fasting glucose, is a risk factor for early-stage atherosclerosis[J]. Diabet Med,2010,27(12):1430-1435.
[4] Yubero-Serrano EM, Delgado-Lista J, Alcala-Diaz JF, et al.A dysregulation of glucose metabolism control is associated with carotid atherosclerosis in patients with coronary heart disease (CORDIOPREV-DIAB study)[J]. Atherosclerosis,2016,253:178-185.
[5] Lüscher TF, Creager MA, Beckman JA, et al.Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part Ⅱ[J]. Circulation,2003,108(13):1655-1661.
[6] 董雪红,胡仁明. 微循环功能的检测方法及其在糖尿病中的应用[J]. 国际内科学杂志,2009,36(4):196-210.
[7] Ma F, Zhao B, Zhang H, et al.Usefulness of enhanced power Doppler imaging in monitoring acral microcirculation in type 2 diabetes mellitus and its complications[J]. Cell Biochem Biophys,2011,61(2):435-441.
[8] Song Y, Li Y, Wang PJ, et al.Contrast-enhanced ultrasonography of skeletal muscles for type 2 diabetes mellitus patients with microvascular complications[J]. Int J Clin Exp Med,2014,7(3):573-579.
[9] Mancini M, Di Donato O, Saldalamacchia G, et al.Contrast-enhanced ultrasound evaluation of peripheral microcirculation in diabetic patients: effects of cigarette smo-king[J]. Radiol Med,2013,118(2):206-214.
[10] Amarteifio E, Wormsbecher S, Demirel S, et al.Assessment of skeletal muscle microcirculation in type 2 diabetes mellitus using dynamic contrast-enhanced ultrasound: a pilot study[J]. Diab Vasc Dis Res,2013,10(5):468-470.
[11] 何婉媛, 周盛, 杨萍, 等. 超声造影定量参数在诊断移植肾急慢性排斥反应的临床价值[J]. 中国超声医学杂志,2017,33(3):249-252.
[12] 董怡, 黄咏红, 陈为民, 等. 超声造影定量评价糖尿病肾病早期肾功能损害的价值[J]. 中国医学影像技术,2011,27(6):1260-1263.
[13] Franjo C, Zeljko M, Cosentino F, et al.Peripheral arterial disease and diabetes mellitus[J]. Diabetologia Croatica,2008,37(2):47-53.
[14] 张瑕, 刘宏伟, 吕雅赐, 等. 糖尿病足溃疡超声造影的影像学特点及临床意义[J]. 南方医科大学学报,2012, 32(3):368-370.
[15] 杨琛, 彭婵娟. 超声造影定量评价体系及其影响因素分析[J]. 中国肿瘤,2016,25(3):212-218.
[16] 董怡, 王文平, 丁红, 等. 实时谐波超声造影技术定量评价正常人肾脏皮质灌注[J]. 中国医学计算机成像杂志,2008,14(2):160-164.
[17] 张驰, 刘若川. 糖尿病患者足部跖背动脉彩色多普勒超声检查的研究进展[J]. 广西医科大学学报,2015,32(5):854-856.
[18] 郝明丽, 徐敏. 代谢组学在2型糖尿病研究中的应用及进展[J]. 内科理论与实践,2016,11(3):191-194.
