目的 应用超声向量血流成像(V-Flow)技术观察糖尿病患者及正常人颈动脉壁剪切力(WSS)分布特征,定量分析不同动脉粥样硬化程度颈动脉WSS的差异.资料与方法 回顾性分析 2019 年 4-6 月在四川省人民医院确诊的糖尿病患者44 例,对44例糖尿病患者(88支血管)和15例正常人(30支血管)进行常规颈动脉超声检查及V-Flow成像,根据颈动脉超声检查结果将糖尿病患者分为内-中膜厚度(IMT)正常组、IMT增厚组和斑块组;观察糖尿病患者与正常人颈动脉不同部位WSS的差异,并进一步分析糖尿病患者各组间WSS的变化特点.结果 本研究中糖尿病患者颈总动脉分叉处和中段WSS(包括WSS最大值和WSS平均值)均小于正常对照组颈总动脉对应部位WSS(P=0.001、0.003),同时正常对照组和糖尿病组颈总动脉分叉处WSS均明显小于颈总动脉中段,差异有统计学意义(P=0.001).糖尿病患者中颈总动脉分叉处WSS的大小随动脉粥样硬化程度的增加而变化(P=0.018、0.043),斑块组最高[WSS最大值(2.58±0.69)Pa;WSS平均值(0.86±0.25)Pa],IMT增厚组次之[(2.37±0.69)Pa;(0.77±0.35)Pa],IMT正常组最低[(2.13±0.52)Pa;(0.69±0.20)Pa],颈总动脉中段WSS差异无统计学意义(P>0.05).结论 糖尿病患者颈总动脉分叉处和中段WSS较正常人颈总动脉对应部位降低,随着动脉粥样硬化程度的增加而变化.超声向量血流成像V-Flow技术对评估糖尿病患者颈动脉粥样硬化进程具有一定价值.
Purpose This study aims to observe the hemodynamic state of the carotid artery in healthy volunteers and diabetes patients via ultrasound vector flow imaging(V-Flow),and to quantitatively analyze the characterization of wall shear stress(WSS)in different degrees of atherosclerosis carotid artery.Materials and Methods This was a cross-sectional study.Forty four diabetic patients diagnosed in Sichuan Provincial People's Hospital from April 2019 to June 2019 were retrospectively analyzed.Routine carotid ultrasound examination and V-Flow imaging were performed on 44 diabetic patients(88 vessels)and 15 controls(30 vessels).According to the results of carotid ultrasound examination,diabetic patients were divided into normal intima-media thickness(IMT)group,IMT thickening group and plaque group.The differences of WSS in different parts of carotid artery between diabetic patients and controls were observed,and the changes of WSS in different groups of diabetic patients were further compared and analyzed.Results In this study,the WSS(including WSSmax and WSSmean)of the bifurcation and middle segment of the common carotid artery in diabetic patients were significantly lower than those in the normal control group(P=0.001,P=0.003).WSS at the bifurcation of common carotid artery was significantly smaller than that at the middle segment of common carotid artery in both normal control group and diabetic group(P=0.001).WSS at the bifurcation of common carotid artery in diabetic patients was changed with the severity of atherosclerosis(P=0.018 and P=0.043),and was highest in the plaque group[WSSmax(2.58±0.69)Pa;WSSmean(0.86±0.25)Pa],followed by IMT thickening group[(2.37±0.69)Pa;(0.77±0.35)Pa].The WSS was lowest in the normal IMT group[(2.13±0.52)Pa;(0.69±0.20)Pa].There was no significant difference in WSS of the middle segment of common carotid artery among the three groups(P>0.05).Conclusion The WSS in the bifurcation and middle section of common carotid artery in diabetic patients is lower than that in controls,and it changed with the increase of atherosclerosis degree.Therefore,the V-Flow technique of ultrasonic vector flow imaging has a certain value in evaluating the progression of carotid atherosclerosis in diabetic patients.