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多普勒超声联合 CT 血管造影在糖尿病下肢动脉疾病中的应用机会及危险因素分析。

Application opportunity of Doppler ultrasound combined with CT angiography in diabetic lower extremity arterial disease and the analysis of the risk factors.

机构信息

Department of Nutrition, The First Hospital of Zhangjiakou, Zhangjiakou, Hebei, China.

Department of Clinical Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.

出版信息

Front Endocrinol (Lausanne). 2024 Jan 30;14:1257241. doi: 10.3389/fendo.2023.1257241. eCollection 2023.

Abstract

OBJECTIVE

This study examined the potential of combining Doppler ultrasound (DUS) and CT angiography (CTA) for early detection and intervention of lower extremity arterial disease (LEAD) in diabetes.Concurrently, risk factors influencing LEAD progression were analyzed.

METHODS

106 Type-2 diabetes patients with LEAD, having undergone DUS and CTA, were divided into four stages according to Fontaine stage. Results of DUS and CTA were compared across stages and potential risk factors were analyzed.

RESULTS

Positive detection rates of LEAD differed between DUS and CTA for Fontaine stages I and II (P < 0.05), with no significant difference for stages III and IV (P > 0.05). CTA identified subgroups with mild to moderate stenosis and severe stenosis or occlusion, with positive rates on DUS of 17.95% and 89.9% respectively. Hypertension was found as an independent risk factor affecting LEAD progression.

CONCLUSION

CTA should be performed early for LEAD in diabetes patients at Fontaine stages I and II, regardless of DUS results. For diabetes patients with LEAD, stringent blood pressure control is crucial to delay disease progression.

摘要

目的

本研究旨在探讨联合应用多普勒超声(DUS)和 CT 血管造影(CTA)对糖尿病下肢动脉疾病(LEAD)进行早期检测和干预的潜力。同时,分析影响 LEAD 进展的危险因素。

方法

106 例经 DUS 和 CTA 检查的 2 型糖尿病合并 LEAD 患者,根据 Fontaine 分期分为四期。比较各期 DUS 和 CTA 的结果,并分析潜在的危险因素。

结果

DUS 和 CTA 对 Fontaine Ⅰ期和Ⅱ期 LEAD 的阳性检出率不同(P<0.05),而对Ⅲ期和Ⅳ期 LEAD 的阳性检出率无显著差异(P>0.05)。CTA 可识别出轻度至中度狭窄和重度狭窄或闭塞的亚组,DUS 的阳性率分别为 17.95%和 89.9%。高血压被认为是影响 LEAD 进展的独立危险因素。

结论

对于 Fontaine Ⅰ期和Ⅱ期的糖尿病 LEAD 患者,无论 DUS 结果如何,都应早期进行 CTA。对于合并 LEAD 的糖尿病患者,严格控制血压对于延缓疾病进展至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1843/10861675/f378d06c5da1/fendo-14-1257241-g001.jpg

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