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目的探讨糖尿病足患者足背动脉超声检测指标与血液流变学之间的相关性。方法51例糖尿病足患者根据肢端有无开放性溃疡分为溃疡组(23例)和无溃疡组(28例),对足背动脉的超声测量参数与血液流变学指标进行多元相关回归分析。结果溃疡组血管内径(D)、收缩期峰值流速(PSV)、阻力指数(RI)、搏动指数(PI)低于无溃疡组,而高切变率全血黏度(BVH)、低切变率全血黏度(BVL)、血浆黏度(PV)、纤维蛋白原(Fib)高于无溃疡组。多元相关回归分析显示BVH、BVL能对D产生影响,偏回归系数(r)分别为-0.004和-0.009;PSV与BVH、PV关系密切,r分别为-0.957、-25.655;而RI与BVH,PI与BVH、PV、Fib关系较密切,r分别为-0.009、-0.141、-2.666、-0.383。结论血液流变学改变可以加重糖尿病足患者下肢小血管的血流动力学异常和血管病变程度,是加剧肢端局部缺血引起糖尿病足溃疡的因素之一。
Objective To investigate the correlation between the index of hemorheology and the indexes of dorsalis pedis artery in patients with diabetic foot. Methods Fifty-one patients with diabetic foot were divided into ulcer group (n = 23) and non-ulcer group (n = 28) according to whether there were open ulcers in extremities. Multivariate regression analysis was performed between the parameters of the dorsalis pedis artery and the indexes of hemorheology . Results The vessel diameter (D), peak systolic velocity (PSV), resistance index (RI) and pulsatility index (PI) in ulcer group were lower than those without ulcer group. BVH, Whole blood viscosity (BVL), plasma viscosity (PV) and fibrinogen (Fib) were higher than those without ulcer. Multivariate regression analysis showed that BVH and BVL had an impact on D, partial regression coefficients (r) were -0.004 and -0.009 respectively; PSV was closely related to BVH and PV, r was -0.957 and -25.655 respectively; while RI and BVH, PI is closely related to BVH, PV and Fib, r is -0.009, -0.141, -2.666 and -0.383, respectively. Conclusion Hemorheological changes can aggravate hemodynamics and vascular lesions of lower extremity blood vessels in patients with diabetic foot. It is one of the factors to exacerbate acral ischemia and cause diabetic foot ulcer.