2型糖尿病合并下肢周围动脉疾病患者颈动脉、椎动脉、锁骨下动脉及肾动脉的数字减影血管造影特征

[Digital subtract arteriographic characteristics of carotid artery, vertebral artery, subclavian artery and renal artery in type 2 diabetic patients with lower extremities peripheral arterial disease].

作者信息

Chen Da-Wei, Lu Wu-Sheng, Wang Chun, Jiao He, Tian Hao-Ming, Ran Xing-Wu

机构信息

Diabetic Foot Care Center, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2012 Sep;43(5):743-6.

PMID:23230752

Abstract

OBJECTIVE

To investigate angiographical characteristics of carotid, vertebral, subclavian, and renal arteries in the type 2 diabetic patients with lower extremities peripheral arterial disease (LEPAD).

METHODS

There were 104 type 2 diabetic patients with LEPAD recruited in this study, who received digital subtract arteriography (DSA). Ankle-brachial index (ABI) assessment was also performed in 50 participants. Dependent upon the stenosis degree of vertebral artery, subclavian artery and renal artery measured by DSA, the patients were divided into normal group (stenosis < or = 50%) or pathological group(stenosis > 50% or blocked lesions). The angiographic features of carotid, vertebral, subclavian, and renal arteries were analyzed and the relationship between arterial stenosis and ABI was explored.

RESULTS

DSA results of 104 patients showed that the most common lesion in the arteries was plaque. The stenosis degrees of 51%-74% and 75%-99% were most commonly observed in renal artery, with incidence of 22.1% and 5.8%, respectively. Arterial occlusion was most commonly observed in vertebral artery, with incidence of 27.9%. The patients with stenosis or occlusion of arteries had lower ABI (P = 0.000), and the patients with stenosis or occlusion of vertebral and renal arteries also had lower ABI (P = 0.003 and 0.02, respectively), compared with those without stenosis. ABI < 0.9 indicated higher risk of stenosis or occlusion of vertebral and renal arteries (P = 0.008 and 0.047 respectively). Between the patients with subclavian arterial stenosis and those without this artery stenosis, there was no statistical significant difference observed in ABI level.

CONCLUSION

Type 2 diabetic patients with LEPAD can affect multiple arteries, showing plaque formation, multi-segmental stenosis and occlusion of arteries. The patients with ABI < 0.9 have higher risk of multiple arterial stenosis or occlusion lesions.

摘要

目的

探讨2型糖尿病合并下肢外周动脉疾病（LEPAD）患者的颈动脉、椎动脉、锁骨下动脉及肾动脉的血管造影特征。

方法

本研究纳入104例2型糖尿病合并LEPAD患者，均接受数字减影血管造影（DSA）检查。50例参与者还进行了踝肱指数（ABI）评估。根据DSA测量的椎动脉、锁骨下动脉和肾动脉狭窄程度，将患者分为正常组（狭窄≤50%）或病变组（狭窄>50%或有闭塞性病变）。分析颈动脉、椎动脉、锁骨下动脉和肾动脉的血管造影特征，并探讨动脉狭窄与ABI之间的关系。

结果

104例患者的DSA结果显示，动脉中最常见的病变是斑块。肾动脉最常观察到的狭窄程度为51%-74%和75%-99%，发生率分别为22.1%和5.8%。动脉闭塞最常见于椎动脉，发生率为27.9%。与无狭窄患者相比，有动脉狭窄或闭塞的患者ABI较低（P = 0.000），椎动脉和肾动脉有狭窄或闭塞的患者ABI也较低（分别为P = 0.003和0.02）。ABI<0.9表明椎动脉和肾动脉狭窄或闭塞的风险较高（分别为P = 0.008和0.047）。锁骨下动脉狭窄患者与无该动脉狭窄患者之间，ABI水平无统计学显著差异。