Abstract：Objective To explore the diagnostic value of ultrasound and related risk factors of lower extremity arterial disease in patients with type 2 diabetes mellitus（T2DM）. MethodsFrom January 2019 to June 2020, 236 T2DM patients with suspected lower extremity arterial disease were selected from the Ultrasound Department of Pidu District People′s Hospital of Chengdu. All patients underwent ultrasound and digital subtraction angiography (DSA). According to the results of DSA, the patients were divided into the lower extremity arterial disease group (n=195) and nonlower extremity arterial disease group (n=41). The results of DSA were used as the gold standard to compare the ultrasound detection rates of patients with lower extremity arterial disease of different severity. Multivariate logistic regression was used to analyze the risk factors of the lower extremity arterial disease in T2DM patients. ResultsA total of 195 cases of 236 patients were diagnosed as lower extremity arterial disease by DSA. The ultrasonic detection rate of grade 1 stenosis was the lowest, only 75.38%（49/65）, while grade 2 was 84.72%(61/72), grade 3 was 90.70%(39/43) and grade 4 was 100.00%(15/15). The difference of ultrasonic detection rate of different severity of lower extremity artery disease in T2DM patients was statistically significant (H=5.14，P＜0.05). The results of univariate analysis showed that the age ［（68.13±7.51）years, （62.07±6.80）years］, duration of diabetes ［（12.38±3.71） years, (10.17±2.85） years］, creatinine levels ［（102.17±20.09）μmol/L, (93.54±23.90）μmol/L］, urea nitrogen levels ［（7.72±2.03）mmol/L, (6.71±1.95）mmol/L］, blood uric acid levels［（472.05±94.18 ）μmol/L, (42105±9058）μmol/L］, statins use rates ［4359%(85/195), 2195%(9/41)］, aspirin use rates ［63.08%(123/195), 36.59%(15/41)］, diabetic peripheral neuropathy rates ［47.18%(92/195), 26.83%(11/41)］, diabetic nephropathy rates ［60.51%(118/195), 34.15%(14/41)］ and hypertension ［82.05%(160/195), 43.90%(18/41)］ were compared between the lower extremity arterial disease group and the non-lower extremity arterial disease group, the differences were statistically significant (t=4.77, 3.60, 2.42, 2.92, 3.17, χ2=6.62, 9.29, 5.70, 9.55, 26.60, all P＜0.05). The results of multivariate analysis on a singlefactor basis showed that prolonged duration of diabetes (OR=1.435, 95%CI：1.095-1.880), higher blood uric acid level (OR=1.467, 95%CI：1.045-2.059), combining with diabetes peripheral neuropathy (OR=1.353, 95%CI：1.024-1.787) and hypertension (OR=1.458, 95%CI：1.134-1.874) were risk factors for lower extremity arterial disease in T2DM patients (all P＜0.05). ConclusionsThe detection rates of lower extremity arterial lesions in T2DM patients of grade 2, 3 and 4 by ultrasonography are higher than that of grade 1 stenosis. T2DM patients with lower extremity arterial disease are mainly affected by the course of diabetes, serum uric acid level, hypertension and diabetic peripheral neuropathy.
李霞 何薇 孙晓玲 郑沙沙 褚洪毅 张旭胜. 2型糖尿病患者下肢动脉病变的超声
诊断价值与相关危险因素分析[J]. 中华诊断学电子杂志, 2021, 9(4): 268-272.
Li Xia, He Wei, Sun Xiaoling, Zheng Shasha, Chu Hongyi, Zhang Xusheng. The diagnostic value of ultrasound of lower extremity arterial disease in type 2 diabetic patients and analysis of related risk factors. zhzdx, 2021, 9(4): 268-272.
