| Objective:To evaluated the characteristics of lower extremity artery plaque between type 2 diabetes mellitus(DM)patients associated with and without hypertension by using multi slice spiral CT angiography(CTA).The relationship between gender,age,course of disease,fasting blood glucose,systolic blood pressure,smoking,drinking and whether taking medicine regularly and other factors with lower extremity vascular high-risk plaque lesions was analyzed.Methods:From January 2016 to January 2021,338 consecutive patients underwent lower extremity CTA in our hospital were retrospectively analyzed.Of 338 patients,50 cases with type 2 diabetes,108 hypertension,72 DM cases complicated with hypertension(mixed group),and 108 patients had normal blood glucose and pressure(control group).The incidence,type and morphology of artery plaque,and the degree of vascular stenosis were compared.Relationship between gender,age,BMI,duration of diabetes and hypertension,fasting blood glucose,systolic blood pressure,smoking,drinking and whether taking drugs regularly and other factors with lower extremity vascular high-risk plaque lesions.Result:A total of 4056 lower extremity arterial segments were included in the analysis of 338 patients,of which 1889 segments(46.57%)showed plaque formation.The plaque of 297(297/600,49.5%),658(658/1296,50.8%)and 535(535/864,61.9%)in diabetes group,hypertension group and mixed group were significantly higher than that of 399(399/1296,30.8%)in control group(all P<0.05).The incidence of calcified plaque in hypertension group was significantly higher than that in diabetes group(23.6%)and mixed group(35.5%),while the incidence of mixed plaque(16.3%)was significantly lower(33.7%,48.0%,all P<0.05).The incidence of type III plaque in diabetes group(47.9%)was higher than that in simple diabetes group(34.1%).The incidence of vascular occlusion was 39.2%in simple hypertension group,48.8%in simple diabetes group and 35.5%in mixed group,and the incidence was higher than that in simple hypertension group(all P<0.05).In the control group,10%patients had high-risk plaques,25%patients had high-risk plaques,60%patients had diabetes,and the highest incidence was in the mixed group(79%)(all P<0.05).The occurrence of high-risk plaque in lower extremity was closely related to age,smoking,diabetes,hypertension and standardized medication(all P<0.05).Conclusion:The incidence of artery plaque in lower extremity of diabetes mellitus and hypertension was significantly increased,but the characteristics and types of plaque were different.The mixed plaque is more common in simple diabetes patients,and the shape is type III,and the lumen is mostly light and moderate stenosis;once hypertension is combined,the incidence of type IV plaque is significantly increased,the incidence of severe vascular stenosis and occlusion is significantly increased,and the incidence of high-risk plaque is significantly increased.Therefore,the monitoring should be focused on in clinical.The incidence of high-risk plaque in diabetes and hypertension patients is obviously high,and the probability of cardiovascular and cerebrovascular events in patients with diabetes mellitus with hypertension will increase significantly.Therefore,CTA is used to screen diabetic lower limb plaque in time,especially for patients with diabetes mellitus with hypertension,which is helpful to provide information for the early clinical focus on different plaque characteristics,and to provide information for the early clinical focus on different plaque characteristics It can provide important basis for the treatment of vascular diseases of lower extremity of different diseases.And we should take positive treatment measures to keep blood sugar and blood pressure in normal range for a long time,avoid blood sugar and blood pressure fluctuation in a large range,so as to delay the development of high-risk plaque. |
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