超声弹性成像评价糖尿病患者坐骨神经生物力学特性的研究
Evaluation of biomechanical properties of sciatic nerve in diabetic patients by ultrasonic elastography
孙友胜 1经朝龙 1陈杰 2金霞 1盛剑 1张建勇 1孙雨菡 1徐子璇 1张辉1
作者信息
- 1. 扬州市中医院超声医学科,江苏扬州 225001
- 2. 扬州市中医院内分泌科,江苏扬州 225001
- 折叠
摘要
目的 探讨超声弹性技术在评价2型糖尿病患者坐骨神经生物力学特性改变中的价值.方法 选择2型糖尿病患者80例(糖尿病组),其中男性40例,女性40例;年龄41～80岁,平均年龄61.56岁;身体质量指数(BMI)19.49～24.48 kg/m2,平均BMI 22.59 kg/m2;糖尿病病程1～15年,平均病程9.96年;收缩压92～138 mmHg,平均收缩压127.33 mmHg;舒张压55～90 mmHg,平均舒张压77.20 mmHg.另选择健康志愿者80例(对照组),其中男性40例,女性40 例;年龄 38～79 岁,平均年龄 60.18 岁;BMI 19.59～24.83 kg/m2,平均 BMI 22.36 kg/m2;收缩压 105～136 mmHg,平均收缩压126.33 mmHg;舒张压60～89 mmHg,平均舒张压78.70 mmHg.应用实时超声弹性成像技术对坐骨神经分叉处上方1 cm处、股骨中段处、臀线处坐骨神经进行弹性评分和测量弹性值,同时取坐骨神经与内侧同水平距坐骨神经1～2 cm处肌层的弹性应变率比值(SR比值).结果 糖尿病组坐骨神经分叉处上方1 cm处、股骨中段处及臀线处的弹性评分、弹性值及SR比值均高于对照组(P＜0.05).糖尿病组坐骨神经出现弹性评分异常占73.7％(59/80),高于对照组的38.7％(31/80)(P＜0.05).糖尿病组301个检查部位弹性评分出现异常,占62.7％(301/480),超过对照组[109个异常,占22.7％(109/480)(P＜0.05)].糖尿病组坐骨神经SR比值与糖尿病病程呈正相关关系(r=0.632,P＜0.05).坐骨神经分叉处上方1cm处、股骨中段处及臀线处坐骨神经SR比值对坐骨神经生物力学特性诊断的曲线下面积(AUC)分别为0.899、0.754、0.630,诊断灵敏度均较高,以分叉处上方1cm处SR最为敏感.结论 超声弹性成像技术能够早期发现糖尿病患者坐骨神经生物力学特性改变,为糖尿病神经并发症的早期诊断与预防提供定量评价指标.
Abstract
Objective To investigate the value of ultrasound elastography in evaluating the biomechanical properties of sciatic nerve in patients with type 2 diabetes mellitus.Methods A total of 80 patients with type 2 diabetes were enrolled as dia-betes group,which included 40 males and 40 females,aged 41-80 years old with mean age of 61.56 years old;body mass index(BMI)was 19.49-24.48 kg/m2 with mean BMI of 22.59 kg/m2;diabetes duration was 1-15 years with mean of 9.96 years;systolic blood pressure was 92-138 mmHg with mean of 127.33 mmHg;diastolic blood pressure was 55-90 mmHg with mean of 77.20 mmHg.The 80 healthy volunteers were selected as control group,which included 40 males and 40 females,aged 38-79 years old with mean age of 60.18 years old;BMI was 19.59-24.83 kg/m2 with mean BMI of 22.36 kg/m2;systolic blood pressure was 105-136 mmHg with mean of 126.33 mmHg;diastolic blood pressure was 60-89 mmHg with mean of 78.70 mmHg.The real-time ultrasound elastography was used to score and measure sciatic nerve elasticity at 1 cm above sciatic nerve bifurcation,middle femur and l line.At the same time,the elastic strain ratio(SR)of muscle layer at 1-2 cm from sciatic nerve at the same level of sciatic nerve and medial side was measured.Results The elastic score,elastic value and SR ratio of 1 cm above sciatic nerve bifurcation,middle femur and hip line in diabetic group were higher than those in control group(P＜0.05).The abnormal elasticity score of sciatic nerve in diabetic group[73.7％(59/80)]was higher than that in control group[38.7％(31/80)](P＜0.05).The abnormal elasticity score in diabetic group[62.7％(301/480)]was higher than that in control group[22.7％(109/480)(P＜0.05)].The SR of sciatic nerve in diabetic group was positively correlated with diabetes course(r=0.632,P＜0.05).The area under curve(AUC)of SR at 1 cm above sciatic nerve bifurcation,middle femur and hip line for diagnosis of biomechanical properties of sciatic nerve was 0.899,0.754 and 0.630,respectively.The diagnostic sensitivity was high,and SR at 1 cm above bifurcation was the most sensitive.Conclusion It is demonstrated that ultrasound elastography could early detect the changes of biomechanical properties of sciatic nerve in diabetic patient,and provide quantita-tive evaluation indicators for early diagnosis and prevention of diabetic neurological complications.
关键词
超声弹性成像/2型糖尿病(T2DM)/坐骨神经/生物力学特性/评估价值Key words
elastic imaging technology/type 2 diabetes mellitus(T2DM)/sciatic nerve/biomechanical properties/evaluation value引用本文复制引用
基金项目
扬州市科技局重点研发项目(YZ2022119)
扬州市中医院院级科技项目(2022TNKT06B)
出版年
2024
NETL
NSTL
万方数据