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2 型糖尿病患者下肢血管疾病、冠状动脉和颈动脉粥样硬化的相关性。

Association of Lower Extremity Vascular Disease, Coronary Artery, and Carotid Artery Atherosclerosis in Patients with Type 2 Diabetes Mellitus.

机构信息

Vascular Surgery, No. 2 Hospital of Baoding, Baoding 071000, China.

Arba Minch Institute of Technology, Arba Minch University, Ethiopia.

出版信息

Comput Math Methods Med. 2021 Oct 16;2021:6268856. doi: 10.1155/2021/6268856. eCollection 2021.

Abstract

The motive of this article is to present the case study of patients to investigate the association between the ultrasonographic findings of lower extremity vascular disease (LEAD) and plaque formation. Secondly, to examine the association between the formation of coronary artery and carotid artery atherosclerosis in patients with type 2 diabetes mellitus. 124 patients with type 2 diabetes (64 males and 60 females with the age group 25-78 years) are considered for the research studies who have registered themselves in the Department of Endocrinology and Metabolism from April 2017 to February 2019. All participants have reported their clinical information regarding diabetes, alcohol consumption, smoking status, and medication. The blood samples from subjects are collected for measurement of HbA, total cholesterol, triglycerides, HDL-c, and LDL-c levels. Two-dimensional ultrasound has been used to measure the inner diameter, peak flow velocity, blood flow, and spectral width of the femoral artery, pop artery, anterior iliac artery, posterior tibial artery, and dorsal artery and to calculate the artery stenosis degree. Independent factors of atherosclerosis are determined by multivariate logistic regression analysis. The results are evaluated within the control group and it is found that there is no significant impact of gender, age, and body mass index ( > 0.05) on the lower extremity vascular diseases. Those with smoking, alcohol consumption, hypertension, and dyslipidemia have higher positive rate ( < 0.05). The type 2 diabetes mellitus group has higher diastolic blood pressure and lower triglyceride ( < 0.05). Diastolic blood pressure, HbA, total cholesterol, HDL-c, and LDL-C are not remarkably dissimilar between the type 2 diabetes mellitus group and the control group ( > 0.05). Compared with the control group, the type 2 diabetes mellitus group has higher frequency of lower extremity vascular diseases in the dorsal artery than in the pop artery ( < 0.05). The blood flow of type 2 diabetes mellitus group is found to be lower than that of the control group, especially in the dorsal artery ( < 0.05). The blood flow velocity of the dorsal artery is accelerated ( < 0.01). Among 117 patients of type 2 diabetes mellitus (94.35%) with a certain degree of injury, there are 72 cases of type I carotid stenosis (58.06%), 30 cases of type II carotid stenosis (24.19%), and 15 cases of type III carotid stenosis (12.10%). Out of 108 subjects in the control group, there are 84 cases of type 0 carotid stenosis (77.78%), 19 cases of type I carotid stenosis (17.59%), 5 cases of type II carotid stenosis (4.63%), and 0 case of type III carotid stenosis (0.00%). Compared with the control group, carotid stenosis is more common in patients with type 2 diabetes mellitus ( < 0.05). Age, smoking, duration of diseases, systolic blood pressure, and degree of carotid stenosis are found to be associated with atherosclerosis. The findings suggest that the color Doppler ultrasonography can give early warning when applied in patients with carotid and lower extremity vascular diseases to delay the incidence of diabetic macroangiopathy and to control the development of cerebral infarction, thus providing an important basis for clinical diagnosis and treatment.

摘要

本文的目的是通过对下肢血管疾病(LEAD)患者的病例研究,探讨超声检查结果与斑块形成之间的关系。其次,研究 2 型糖尿病患者冠状动脉和颈动脉粥样硬化形成之间的关系。

2017 年 4 月至 2019 年 2 月期间,在内分泌和代谢科登记的 124 名 2 型糖尿病患者(男性 64 名,女性 60 名,年龄 25-78 岁)被纳入研究。所有参与者均报告了与糖尿病、饮酒、吸烟状况和药物治疗有关的临床信息。从受试者采集血样,测量 HbA、总胆固醇、甘油三酯、HDL-c 和 LDL-c 水平。二维超声用于测量股动脉、 pop 动脉、髂前动脉、胫后动脉和背动脉的内径、峰值流速、血流和频谱宽度,并计算动脉狭窄程度。采用多因素 logistic 回归分析确定动脉粥样硬化的独立因素。在对照组中进行评估,结果发现性别、年龄和体重指数(>0.05)对下肢血管疾病无显著影响。有吸烟、饮酒、高血压和血脂异常的患者阳性率更高(<0.05)。2 型糖尿病组舒张压和甘油三酯较低(<0.05)。2 型糖尿病组与对照组的舒张压、HbA、总胆固醇、HDL-c 和 LDL-C 无显著差异(>0.05)。与对照组相比,2 型糖尿病组背动脉下肢血管疾病的发生率高于 pop 动脉(<0.05)。与对照组相比,2 型糖尿病组血流较低,尤其是背动脉(<0.05)。背动脉血流速度加快(<0.01)。在 117 例有一定程度损伤的 2 型糖尿病患者(94.35%)中,有 72 例颈动脉 I 型狭窄(58.06%),30 例颈动脉 II 型狭窄(24.19%),15 例颈动脉 III 型狭窄(12.10%)。在对照组 108 例中,有 84 例颈动脉 0 型狭窄(77.78%),19 例颈动脉 I 型狭窄(17.59%),5 例颈动脉 II 型狭窄(4.63%),无颈动脉 III 型狭窄(0.00%)。与对照组相比,2 型糖尿病患者颈动脉狭窄更为常见(<0.05)。年龄、吸烟、病程、收缩压和颈动脉狭窄程度与动脉粥样硬化有关。这些发现表明,彩色多普勒超声可对颈动脉和下肢血管疾病患者进行早期预警,延缓糖尿病大血管病变的发生,控制脑梗死的发展,为临床诊断和治疗提供重要依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfe0/8541854/d3d5a9acb654/CMMM2021-6268856.001.jpg

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