| Objective :The pulse wave velocity of the common carotid artery in type 2 diabetic mellitus patients was detected by ultrafast pulse wave velocity(UFPWV)to explore the application value of the technique in quantitative evaluation of the common carotid vascular wall elasticity of patients with type 2 diabetes mellitus.Methods : One hundred and twenty patients with type 2 diabetes,who were hospitalized in the endocrinology department of the First Affiliated Hospital of Bengbu Medical College in Anhui Province from July 2018 to June 2019 and underwent vascular ultrasound examination at the ultrasound department,were selected as the case group of this experiment.According to the carotid intima-media thickness(IMT),the experiment group was then divided into group A(IMT normal group),group B(carotid IMT thickening group),and group C(carotid atherosclerotic plaque group),while group A included A1(lower extremity atherosclerotic plaque group)and A2(lower extremity arteries without plaque group)based on the lower extremity arteries with or without plaque.Meanwhile,60 volunteers with normal blood glucose and IMT,who went through physical examination at the physical examination center of the First Affiliated Hospital of Bengbu Medical College,were selected as a control group.Equipment: The Color Doppler Ultrasound Diagnostic Instrument of Supersonic Imagine Aixplorer manufactured by French Acoustics Company was used,and the SL15-4 linear array probe was also provided with the frequency between 4 and15 MHz.Select Vascular conditions,built-in ultrafast pulse wave velocity technology.Procedure:(1)IMT measurement: scanning on the longitudinal section at 1-1.5cm below the bifurcation level of the common carotid artery,the vascular wall was clearly visible,and there is no artifact interference in the lumen.After the image was frozen,measuring the IMT of the posterior wall of the vascular wall,as well as recording whether or not there was a plaque.(2)PWV measurement: The longitudinal scan was performed to 1-2cm of the common carotid artery bifurcation.Adjust the operation to clearly display the intima-media(especially the anterior wall)of the common carotid artery.Then let the subject to hold breath and immediately touch the "PWV" key,followed by an automatic acquisition time for 2-3s,requiring the examiner to maintain the probe stable and the subject not to move his or her neck.After entering the image processing stage.Adjust the position of the sampling frame to select the target segment when the endometrial tracing was not satisfactory.The sampling frame should contain as much information as possible so that the endometrial line was consistent with the target segment.Click the "Select" button on the control panel to display the speed-time color map of the anterior wall movement of the target segment.The system automatically calculated PWVBS,PWVES and the corresponding standard deviation.The system automatically calculated PWVBS,PWVES and the corresponding standard deviation(less than 20 percent of the corresponding value)of PWVBS and PWVES.(3)Lower limb artery examination:Explore lower limb arteries along the body surface markers of the artery.Starting with the femoral artery,gradually scan to the distance until reach the dorsal artery(Including femoral artery,popliteal artery,anterior tibial artery,posterior tibial artery,peroneal artery,dorsal plantar artery).When examining the popliteal artery,prone position should be adopted,with feet raised 20-30 degrees upward to relax muscles.Result:(1)Comparison of carotid artery elasticity parameters between the experimental group with type 2 diabetes patients and the control group: the values of PWV-BS and PWV-ES were higher than those of control group,and the differences were statistically significant(P values<0.05).(2)Comparison of carotid artery elasticity parameters between variousexperimental groups with type 2 diabetes patients and the control group,the results of carotid artery PWV-BS and PWV-ES in group A,group B,group C and the control group were gradually increased,and the differences were statistically significant(P values<0.05).(3)Within IMT normal group in the experimental group of type 2 diabetes patients,the PWVBS,PWVES and IMT values of carotid artery elasticity parameters in the group with plaque of lower limbs were all higher than those in the group without plaque.The differences of PWVES were statistically significant,P < 0.05,but there was no statistical significance on the differences of PWVBS values and IMT values,P>0.05.(4)According to the ROC curve of PWVES value in diagnosing atherosclerosis of type 2 diabetes mellitus,the diagnostic threshold of PWVES is 8.15,the sensitivity is 0.83,the specificity is 0.80,and the highest Jordan index is 0.63.Conclusion:(1)The PWVBS and PWVES of carotid artery elasticity parameters of T2DM patients were significantly higher than those in the control group,indicating that carotid artery elasticity of T2 DM patients was lower than that of normal people.(2)Indicating carotid artery elastic in control group,normal carotid artery group, carotid IMT thickening group and carotid atherosclerotic plaque group were gradually reduced;(3)In patients with type 2 diabetes showing no change in carotid artery morphology(IMT < 1.0),the carotid artery elasticity decreased in patients with plaque of lower limbs.(4)PWVES > 8.15 m/s can be used as a diagnostic standard for early detection of atherosclerosis in patients with type 2 diabetes. |
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