【Summary 】 purpose:The outbreak rate studied diabetes(DM) merger high blood pressure(HP) a sufferer the legs artery gruel kind to harden(AS), value the DM merger HP sufferer AS’s prevention and cure, for clinical provide theories basis.Method:The applied high Pin much more colorful Pu Lei super voice observes 120 DM merger HP sufferer(A set) and 98 pure DM legs artery of sufferer’s matched control(B set)s.To two sets of legs arteries inside-in film thickness, have already had no occurrence that gruel kind hardens a spot piece and take care of path narrow or out-of-the-way and the blood dynamics change carry on a comparison.Result:A set legs blood vessel tube chamber of inside-in film thickness, harden spot piece, narrow, out-of-the-way of the incidence rate be obviously high at the B set.Inside-in the incidence rate of film thickness increment and hardening spot piece is been obvious by artery, but take care of a chamber is narrow, out-of-the-way with before the Jing artery is heavy, instep artery time it.Conclusion:DM merger HP sufferer more pure DM sufferer more easily erupts and aggravates the legs AS and the high Pin much more colorful Pu Lei super voice check can provide a dependable information for the clinical diagnosis and treatment and be advantageous to a clinical doctor to make exactitude judgment and adopt to correspond treatment measure to the condition.
The diabetes(diabetes mellitus, DM) is clinical with high blood pressure(hypertension, HP) familiar of two kinds of familiar diseases, all easily merge afferent pathological changes.Because the DM falls ill a year by year rise of the rate, various chronic complications also corresponds increment and among them, the legs artery gruel kind harden(atherosclerosis, AS) to become one of the DM clinical main and afferent disease, but the legs artery pathological changes cause to lack blood to have in the outbreak of DM foot very important function ［ one ］ .According to statistics the DM sufferer’s legs to cut a limb rate more 500% ～s in height than normal person 1000% ［ss is 2 ］s.Moreover the HP is again one of the dangerous factors that the DM erupts an afferent pathological changes, several researches express that twos present just related.This text passes much more colorful Pu Lei a super voice a check legs blood vessel, study DM merger HP a sufferer to be like with pure DM sufferer’s legs afferent voice to learn a change and understand two diseases to merge by period whether raise an AS outbreak rate, merge for the clinical DM thus HP the sufferer provide prevention and cure basis, help clinical well control a condition and estimate symptoms progress, further prevention and decrease the heart cerebral paroxysm occurrence, exaltation DM the sufferer exist quality.
One data and method
1.1 objects originally the text collected from September, 2003 to is a pair of super sufferer with colourful legses arteries in super voice section in my hospital in April, 2007, will through clinical confirm of the DM merge HP sufferer’s 120 be observation set(A set)s.The DM brings into standard to press 1999 the west of the DM alliance too the area committee put forward of diagnosis standard:Empty stomach blood sugar ≥ 7.0 mmols/L(the ≥ 126 mgs), the 11.1 mmols/L(the ≥ 200 mgs) of the after meal 2 h blood sugar ≥ , the 11.1 mmols/L of the 2 h blood sugar ≥ after the 75 g glucose burden;(≥ 200 mgs)The high blood pressure matches 1999 WHO ISH diagnosis standard:The constringency presses the ≥ 140 mmHgs with/or comfortable Zhang Ya ≥’s 90 mmHgs, expel to deliver sex high blood pressure at first.Observation set the age 47-year-old ～ be 90 years old, the average ge is 70.4 years old, male’s 69, female 51.The matched control is 98(B set), the choice same period hospitalization confirms for the DM a sufferer but has no HP, the age 43-year-old ～ is 88 years old, average the age be 70.1 years old), male 52, female 46.2 sets all have no serious heart cerebral complications.(the brain Geng dead, coronary, myocardial Geng dead, angina pectoris, DM foot etc.)
1.2 day of method adoptions sign the company HITACHI EUB5500 and Philip to fly any multi-function and high Pin much more colorful Pu Lei a super voice a diagnosis instrument and stretch forward the frequency as 6 MHz ～ 13 MHzs.BE take by check even lie or the Fu lie, full revelation double legs, normal regulations check double deep shallow artery, 腘 artery of the artery, of the artery, with total side, before the Jing after the artery, Jing the artery and the instep artery, follow blood vessel to walk to go to make Zong to slice and the cross section sweep to check and observe whether film surface inside the afferent wall is smooth or not, inside-in film thickness(IMT), have have no gruel kind harden spot piece, record a spot piece size, appearance, part and echo type combine calculation tube the path narrow rate.The legs artery gruel kind hardens a two-dimensional voice to be like diagram:Expressed for film inside the artery to slightly increase in early days thick, break continuously, the echo strengthen, the part see the light degree swell up, legs artery of inside-in film thickness>1 mm.The course of illness develops further, inside the wall can appear the spot piece that the size doesn’t wait and take care of a chamber to present different degree of narrow.The normal regulations measures position of take care of the path for:Total artery, 腘 artery the crotch be near to carry an ex-1 cm, deep artery, shallow artery, the artery is be apart from a start department about the 1 cm after the artery, Jing before the Jing, instep artery while handing over 1 cm in the boundary distant place with ankle joint, having a narrow tube chamber at narrow most obvious the place measure.Much more colorful blood of Pu Lei develops the observation tube chamber Chong Ying degree and pulse many Pu Leis(PW) measured Feng value current velocity(PSV) and comfortable piece of each artery blood and don’t expect current velocity(EDV).Compute a narrow degree formula=［ (De － Ds)/ De ］ the × be 100%.(the Ds is valid to take care of path, De is path inside the blood vessel)Each time piece according to measure 3 times, take it to equally be worth.Take care of path narrow divide 4 class ［s 3 ］s according to the degree, 0 classes:Normal;Ⅰ Class:Take care of path narrow<50%, still have no obvious blood dynamics change;Ⅱ Class:Taking care of path narrow and 51% ～s is 99%s and have obvious blood dynamics a change;Ⅲ Class:Take care of a chamber completely out-of-the-way, inside have no blood signal.
1.3 covariances learn analysis IMT adoption all set few ±s Sigma mean, the comparison adoption t examine;Each afferent masculine gender rate comparison adoption χ 2 examination, with P<0.05 for covariance’s learning difference have already shown Zhao meaning.
2 results
2.1 checks express 120 DM merger a HP set the legs blood vessel a tube a chamber hardening a spot piece as a result, narrow, out-of-the-way of the incidence rate be obviously high at the matched control.(table 1)
The form 1 DM merger HP set and matched control legs afferent pathological changes masculine gender the comparison of the rate(slightly)
Note:Narrow:51% path inside the ≤ blood vessels reduce ≤ 99%, *P<0.05
2.2 high resolution two-dimensional super voice the picture was clear to show the structure of the artery wall normal legs artery a tube the wall presents two parallel and high echos to only take, respectively is inside the echo of film, outside film, inside of film, outside film thinner intermediate for loiter a voice.The pathological changes legs artery tube film inside the wall increase thick, owe smooth, deliver size more not to wait to loiter a voice inside tube chamber, strong echo harden spot piece formation.This research result expresses DM merger HP a sufferer the IMT thickness compares to increase with matched control obviously thick, the difference has to show Zhao.(see table 2)The artery IMT is the most thick to be a shallow artery, but take care of path in the DM the merger the HP set narrow with out-of-the-way part the artery much sees before the Jing, secondly for the instep artery.(see table 3)
The form 2 DMs merge HP sufferer and the thickness comparison sheet of the matched control IMT(slightly)
Note:A set and B set comparison P=0.0010
The incidence rate of the form 3 DM pathological changes with afferent legs of the merger HP set(120)(slightly)
Note:Narrow:51% path inside the ≤ blood vessels reduce ≤ 99%
2.3 much more colorful Pu Leis show that the blood signal for tube chamber to have no narrow is full of a tube a chamber, the PW presents a layer to flow a frequency chart;The gruel kind hardens spot formation to see colorful blood Chong Ying defection and damage and be narrow>51%, tube the chamber narrow place or close to the its downstream blood bunch become thin, parts of cases present brilliant colors to inset a blood, the PW shows narrow place Feng a value current velocity speed, comfortable Zhang Qi2 Fan3 to wave crest the value soon lowers or disappears;Have no blood signal inside out-of-the-way segment, the PW can’t measure blood frequency chart.Multistage segment pathological changes see obscure blood signal inside distant artery, change into a low resistance blood, the PW shows for the list mutually low speed wave a type.There is side circulation formation, also see weak blood signal.
3 discussions
Live continuously raise of the level along with people currently, the meal structure took place variety, the high fat, high cholesterol food absorb excessive, another work pressure big, live rhythm of speed, people are engaged in the decrease that the athletics toughens an activity to wait various reason and resulted in the DM merge HP the sufferer increases day by day.All of DM, HPs is arteries gruel the kind harden of important and dangerous factor, although their property dissimilarity, all injure skin inside the blood vessel, the skin function obstacle and structure abnormality inside the occurrence.Inside the skin function abnormality also has something to do with dangerous factor exist of amount ［ 4 ］s.While there is research discovering DM merger HP, inside skin dependence afferent and comfortable piece the harm of the function aggravates ［ 5 ］s further.Normal skin inside the artery has anti- AS and anti- blood to bolt to fill of function, inside the skin function obstacle will directly cause artery occurrence afferent wall fatty and thick, the gruel kind harden a spot piece, the formation causes the gruel kind harden thus of occurrence.Diverse return to return an analytical manifestation, the HP is the independent dangerous factor of the afferent pathological changes of 2 DM sufferers and constringency’s pressing to go up be the DM surroundings afferent pathological changes related dangerous factor while also having domestic research’s ［’s 6 ］ manifestations to hospitalize.And the high blood pressure is in 2 DM sufferers of fall ill a rate to want obviously high have 40% around at the age of 45, and arrive at the common crowd will increase to about 60% at the age of 75, greatly parts of sufferer’s blood pressures didn’t get a good control, high blood pressure with the result that the AS function also has something to do with its influence skin inside the blood vessel and film transparence inside the smooth muscle cell and aggravating the film in the blood vessel harm wait.AS is a kind of chronic, carry on sex, many factor of system disease, the DM legs afferent pathological changes is a DM familiar complications and the pathological changes mainly involves in the knee following artery.Take care of the wall increase thick, spot piece formation, tube the chamber be narrow with out-of-the-way, is a legs artery the important and pathologic process of the pathological changes.The DM sufferer has already existed artery hardening before the afferent appearance learn change, the merger HP will aggravate the degree of artery hardening, can cause serious legs afferent complications, like DM foot etc., seriously endanger the sufferer’s living quality and healthy longevity.AS with the result that afferent wall structure of the pathology change at the B type super voice to develop under the main performance for:The afferent wall increase thick(mainly inside-in film) and spot piece the formation ［ be 7 ］s.Pathologic in recent years with super voice research think inside-in the film increase thick is an AS earlier period to advertise for, the gruel kind spot piece then AS dependable proof.Occurrence at legs artery of gruel kind harden pathological changes, light can have no symptom, the voice is like diagram a top a performance for inside film hair Cao, continuous sex break off, the echo strengthen, the IMT increase thick or spread at of small spot piece formation;If the IMT increase thick obvious or the spot piece more and greatly causes an afferent chamber narrow and can appear the legs limb to carry to lack blood and surroundings nerve pathological changes;But the legs artery lack the blood has already emphasized to want a function in the DM foot the outbreak, and disadvantage in ulcerate with heal of bad Ju the ［ be 8 ］s.This research discovers that the artery IMT is the most thick to be a shallow artery, but take care of path in the DM the merger the HP set narrow with out-of-the-way of part the artery much sees before the Jing, secondly is instep artery.This explains that the small artery more easily takes place narrow is to out-of-the-way.This is probably smaller with small artery oneself tube chamber, even is slightly inside the film pathological changes can also cause tube chamber out-of-the-way, cause clinical disease, so we choose legs an afferent and super voice diagnosis to make sure DM merger whether HP more easily appears AS or not, thus better understanding the whole body afferent pathological changes.This text uses the double which examines a sufferer of high Pin much more colorful Pu Lei super voice side legs artery, result manifestation DM merger HP sufferer IMT increase thick and harden spot piece of incidence rate and matched control compare, the difference has covariance to learn meaning(P<0.05), this expresses that the DM merge HP and legs AS have close relativity, this perhaps is the DM merge HP sufferer alter merge afferent pathological changes of reason place.Have a data manifestation an adoption a tube path a narrow rate judgment artery narrow the degree be more pure to mean sensitive by IMT.Currently DM merger HP of clinical the diagnosis be not difficult, but in early days have cerebral heart a merger disease a sufferer have no the typical model clinical symptom, because of from the AS arrive appear a clinical body to advertise for like angina pectoris, myocardial Geng dead, the brain Geng die and body artery’s stopping up sex disease’s etc. be one endless concealment process, but once sufferer’s appearing clinical symptom has already belonged to a later period, its occurrence life dangerous of all the rate will consumedly increase.Therefore, for this kind of sufferer should the normal regulations carry on legs an afferent and super voice a check, regardless near carry greatly, medium the blood vessel have have no AS spot piece or narrow pathological changes, all should early check understanding body distant rtery blood vessel provide a blood circumstance, in order to discovered an afferent pathological changes in early days and made an intervention a treatment.On the Zong say, early check to these sufferers, early diagnose and early cure to seem to be as importance.But use high Pin much more colorful compose the Lei super voice not only can measure inside artery-in film thickness, can observe size, appearance and inner part structure circumstance that the gruel kind hardens a spot piece again, take care of a chamber narrow, after hair the blood bolt formation, out-of-the-way, also can prognosticate blood condition, its resolution can reach to a 0.1 mms, can keep a view and accurately reflect an artery hardening circumstance, is the in addition to DSA and MRI best of do not create a sex check method.Its price isn’t high, the operation tube list, re-usable examination and sufferer are easy to accept an etc. characteristics, to DM merger HP sufferer, pass a super voice an examination, can for clinical provide artery afferent earlier period the diagnosis of the pathological changes basis, and ability dynamic state observation AS progress with fade away a circumstance, contribute to clinical control a condition and open an exhibition treatment, prevent°from the heart cerebral disease and the occurrence of the complications a development
Powered by
Recent Comments