| Objective:To explore the clinical value of ultrasound diagnosis of lower extremity arterial disease in patients with type 2 diabetic mellitus(T2DM),and the correlation between the intimal medial thickness(IMT)of lower extremity artery and the serum inflammatory index neutrophil to lymphocyte ratio(NLR)was analyzed.Methods:A total of fifty patients with T2DM who were treated in the endocrine department of First Affiliated Hospital of Guangxi Medical University from September 2017 to September 2018 were enrolled as the study group.Another fifty nondiabetic patients were selected as the control group.Ultrasound examination was performed on the lower extremity vessels,along the lower extremity vessels,the bilateral femoral artery,popliteal artery,posterior tibial artery,anterior tibial artery and dorsalis pedis artery were tested.The incidence of plaque,the echo characteristics of plaque and the location of plaque were recorded.The distribution of lower extremity arterial disease in diabetes patients were analyzed.Neutrophil counts and lymphocyte counts were collected from the blood routine examination of the patients.NLR was calculated.The results of ultrasound in the two groups was compared by?~2 test.IMT,peak systolic velocity(PSV),blood flow volume(BFV)of common femoral artery,popliteal artery and dorsalis pedis artery and neutrophil counts,lymphocyte counts and NLR were compared between the two groups by independent sample t test.Finally,Pearson correlation analysis was used to analysis the correlation between IMT and NLR.Results:The smooth rate of lumen intima in the study group was lower than that in the control group,and the rate of plaque with no smooth surface in the study group was higher than that in the control group,the comparison between groups had statistical significance(P<0.05).The ultrasound examination showed that there were 45 cases of plaque in the lumen of patients with the study group,the distribution of plaque from high to low in the lower extremity artery was 43 cases(95.56%)of dorsalis pedis artery,40 cases(88.89%)of the anterior tibial artery,38 cases(84.44%)of posterior tibial artery,32cases(71.11%)of popliteal artery and 29 cases(64.44%)of femoral artery,among them,31cases were distributed in 2 or more lower extremity arteries.The IMT of common femoral artery,popliteal artery and dorsalis pedis artery average in the study group were higher than control group,the difference were statistically significant(P<0.05),the PSV,BFV of common femoral artery,popliteal artery average in the study group were higher than control group,the PSV of dorsalis pedis artery average in the study group were higher than control group,the BFV of dorsalis pedis artery average in the study group were lower than control group,the difference were both no statistically significant(P>0.05).The neutrophil counts and NLR in study group were higher than the control group,the lymphocyte counts were lower than the control group,comparison between groups with statistical significance(P<0.05).The relativity analysis shows that IMT of common femoral artery,popliteal artery and dorsalis pedis artery were positively correlative with NLR,the correlation coefficients were respectively0.260,0.515,0.538(P<0.05).Conclusions:Ultrasound has important clinical value in the diagnosis of lower extremity arterial lesions in patients with type 2 diabetic mellitus.It helps clinicians grasp the morphology and hemodynamic state of lower extremity arteries by assessing the IMT,the incidence of plaque,the location of plaque and provide the hemodynamic information.Lower extremity arterial lesions in patients with T2DM often involve the distal artery below the knee joint,and the lesions are usually dense,small,needle-like strong echoes,mostly are bilateral and multiple segmental arteries involved.IMT has closely relationship with NLR,the combination of application of ultrasound and NLR can provide the objective basis for early diagnosis and assessment of the lower extremity arterial lesions in patients with T2DM. |
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