［摘要］ 目的:探讨代谢综合征（metabolic syndrome, MS）患者的下肢动脉病变情况。方法:应用彩色多普勒超声对50例MS患者下肢动脉进行检查，并与30例健康志愿者对照，测量血管内径、收缩期最大流速、内中膜厚度、斑块大小及数目。结果:50例中，内中膜增厚大于1.1 mm者41例，有粥样斑块并引起不同程度狭窄者33例。股总动脉、动脉、足背动脉的内膜明显厚于对照组（P＜0.01或P＜0.05)，斑块数明显多于对照组（P＜0.01)。结论:MS患者下肢动脉发生了程度不等的病变，用彩色多普勒超声检测能明确MS患者下肢动脉病变的部位和程度，具有重要的临床意义。
［关键词］ 代谢综合征; 下肢动脉; 超声检查，多普勒，彩色
Color Doppler ultrasound study on pathological changes of lower extremity arteriesin patients with metabolic syndrome
ABSTRACT Objective: To explore the pathological changes of lower extremity arteries of patients with metabolic syndrome. Methods: Fifty patients with metabolic syndrome (MS) and 30 normal volunteers were included in this study. The inner diameters, peak systolic velocities and intimamedia thicknesses of the lower extremity arteries, and the sizes and numbers of the plaques in the lower extremity arteries were obtained with color Doppler ultrasound (CDU). Results: In the fifty MS patients, the intimamedia thicknesses of fortyone were thicker than 1.1 mm and thirtythree had plaques which had brought stenosis in different degrees. The intimamedia thicknesses of the common femoral, popliteal and posterior tibial arteries in the MS patients were significantly thicker than those in the normal volunteers (P＜0.01 or P＜0.05), and a greater number of plaques in the lower extremity arteries were observed in the patients, as compared with the normal volunteers (P＜0.01). Conclusion:Various pathological changes had taken place in the lower extremity arteries of the MS patients. The sites and degrees of the lower extremity arterial diseases in MS patients can be definitely detected with CDU.
KEY WORDS metabolic syndrome; arteries, lower extremity; ultrasonography, Doppler, color
伴随着现代文明的发展，代谢综合征（metabolic syndrome, MS）的发病率显著上升，已严重危害人类的身心健康。研究表明MS可加速动脉粥样硬化的发生发展［1］，且MS患者颈动脉粥样硬化程度较单纯高血压病和糖尿病患者更为严重［2］。那么MS与下肢动脉病变的关系如何呢？目前国内尚少有相关报道。彩色多普勒超声在下肢动脉病变诊断中的实用价值已得到广泛认可［3～7］，本研究应用彩超检查观察了MS患者下肢动脉病变的特征，旨在探讨MS与下肢动脉病变的关系，为代谢综合征血管损伤的防治提供临床依据。
1 资料与方法
1.1 诊断标准 MS的诊断依据1999年WHO诊断标准［8］，即基本要求：糖调节受损或糖尿病和(或)胰岛素抵抗背景人群,钳夹试验中葡萄糖摄取率下四分位数以下。尚有下列2个或更多成分:血压增高≥140/90 mmHg；血浆甘油三酯增高≥1.7 mmol/L和(或)高密度脂蛋白胆固醇（high density lipoprotein cholesterol, HDLC）降低，男性＜0.9 mmol/L（35 mg/dl）,女性＜1.0 mmol/L（39 mg/dl）；腹型(内脏)肥胖,腰臀比(waist hip ratio, WHR)男性＞0.90,女性＞0.85和(或)体重指数(body mass index, BMI)＞30 kg/m2；尿微量白蛋白≥20 μg/min或白蛋白/肌酐≥30 mg/g。
1.2 临床资料 MS组50例，为2004年1月～2005年1月门诊及住院患者，其中男27例，女23例，年龄50~86岁，平均66.4岁，均为依据1999年WHO诊断标准确诊的MS患者，其中49例为糖尿病合并原发性高血压患者。对照组30例，为依据1999年WHO诊断标准排除了MS的健康志愿者，男19例，女11例，年龄44～79岁，平均63.7岁，均无糖尿病及高血压病。
1.3 检查方法
1.3.1 仪器 使用Philips HDI5000彩色多普勒超声诊断仪，探头频率5～12 MHz。
1.3.2 超声检查方法 检查股总、股浅动 1 2 3 下一页
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