| Objectives To evaluate the characteristics and microvascular distribution of carotid plaques in patients who with diabetes mellitus by conventional ultrasound and contrast-enhanced ultrasound(CEUS).And analyze the correlation between carotid plaque ultrasound characteristics and blood glucose,glycosylated hemoglobin,insulin,C-peptide levels in type 2 diabetic patients(T2DM)with or without hyperlipidemia,and to provide a basis for clinical comprehensive evaluation of the characteristics and stability of carotid plaques in patients with T2DM.Methods 148 patients with carotid artery plaque thickness>2.0 mm who were treated in our hospital from October 2019 to September 2020 were selected,including 100 T2DM patients as T2DM group and 48 non-diabetic patients as non T2DM group.Routine ultrasound and contrast-enhanced ultrasound were performed to observe and compare the location,size,echo,ulceration and enhancement of plaque between the two groups The patients with or without hyperlipidemia were divided into T2DM with hyperlipidemia group(group A)and T2DM without hyperlipidemia group(group B).The plaque characteristics and microvascular distribution were compared between group A and group B the patients with T2DM were followed up for 6 months to observe the changes of plaque two-dimensional ultrasound characteristics.The measurement data were expressed (?)±s and the comparison between groups was by t test or paired t test;the count data were expressed by rate,and the comparison between groups was by chi square test and Fisher exact probability method.Nonparametric test was used to compare the rank data between groups,and Pearson correlation was used to analyze the correlation.The difference was statistically significant(P<0.05).Results 1 Comparison of general data:there were no significant differences in age,gender,BMI,smoking,drinking,TC,TG and LDL-C between the two groups(P>0.05);there were significant differences in HDL-C and FPG between the two groups(P<0.05).2Comparison of conventional ultrasound features:In non T2DM group,the main plaque location was common carotid artery bifurcation internal carotid artery origin,while in T2DM group,the main plaque location was common carotid artery bifurcation.The difference in plaque location between the two groups was statistically significant(P<0.05);However,there was no significant difference in these aspects of plaque,such as left and right sides,anterior and posterior walls,inner and outer sides,plaque echo,calcification,calcification location and plaque length(P>0.05);while,the plaque thickness,whether there was very low echo in the plaque and whether there was ulcer in the plaque were statistically significant(P<0.05).3 Comparison of contrast-enhanced ultrasound results:on the long axis,the enhancement of the proximal and thickest and distal segments of the plaque between T2DM group and non T2DM group was observed,and the difference between the two groups in proximal was statistically significant(P<0.05),but there was no statistically significant difference between the distal and thickest segments(P>0.05);On the short axis,the enhancement of the proximal,thickest and distal segments of the plaque was observed The difference was statistically significant(P<0.05);the difference was not statistically significant(P>0.05).4 In T2DM patients,plaque length was correlated with the following indicators:fasting blood glucose(FBG),glycosylated hemoglobin A1_C(Hb A1_C),and postprandial blood glucose(PBG),respectively,the correlation coefficients were 0.290,0.453,0.342.Unfortunately,plaque length is closely related to fasting insulin(FINS)and 2 h postprandial insulin(FINS-2h).The plaque thickness was correlated with FBG,Hb A1_C,PBG and FINS,respectively,the correlation coefficients were 0.378,0.720,0.389 and 0.329.However,the plaque thickness was not correlated with FINS-2h,fasting C peptide and postprandial 2h C peptide.5 According to whether they were complicated with hyperlipidemia or not,the patients were divided into T2DM with hyperlipidemia group(group A)and T2DM without hyperlipidemia group(group B).The plaques in the group without hyperlipidemia were longer,thicker,calcified and ulcerated.While there were no significant differences in other indexes(P>0.05).6 After 6 months of follow-up,the thickness of T2DM group was smaller in 38 cases and increased in 6 cases;In terms of the length,36 cases were decreased and 8 cases were increased.Conclusions 1 Thicker plaques and more neovascularization were found in patients with T2DM,which indicates that T2DM may be one of the important factors to promote plaque growth and neovascularization in plaque.2 For T2DM patients,the length of plaque is positively correlated with FBG,Hb A1_C and PBG;the thickness of plaque is positively correlated with FBG,Hb A1_C,PBG and FINS,among which Hb A1_C has the highest correlation.3 There are the characteristics of thinner thickness,shorter length,less calcification and ulcer of carotid plaques in T2DM patients with hyperlipidemia.4 After regular medication,the plaque of T2DM patients may retract.Figure11;Table15;Reference 138... |
PDF Full Text Request