Application of high frequency color Doppler technique in examination of dorsalis pedis vascular lesions in patients with type 2 diabetes mellitus

ZHAO Feng; DING Ying; ZHANG Tao

doi:10.3969/j.issn.1002-7386.2018.03.001

Abstract：Objective To predict the incidence of diabetic foot in patients with type 2 diabetes mellitus (T2DM) by examining dorsalis pedis artery with 18MHz high frequency color Doppler ultrasonography.Methods A total of 188 patients with T2DM who underwent routine physical examination in community hospitals from October 2014 to August 2016 were divided into concurrent diabetic foot group (n =59) and non-concurrent diabetic foot group (n =129) by the professional doctor according to the specific circumstances of patients.First of all,the general clinical data of patients including gender,age,BMI index,course of diabetes were recorded in detail.Then blood specimens of patients were collected,and the blood glucose levels and inflammatory indexes were detected,including fasting blood glucose (FPG),postprandial 2h blood glucose (2h-PG),glycosylated hemoglobin (HbA1 c),white blood cell count (WBC) and C-reactive protein (CPR).Then dorsalis pedis artery was examined by using 18MHz high frequency color Doppler ultrasonography,and blood flow (BF),arterial diameter (BD),intima-media thickness (IMT),peak flow rate (PFV),end diastolic velocity (EDV),mean velocity (MFV) and pulsatility index (PI) were detected and compared between two groups.Results There were no significant differences in gender,age,BMI and FPG between two groups,however,there were significant differences in the length of disease course,2h-PG,HbA1 c,WBC and cRP between two groups (P ＜ 0.05).The examination results by high frequency ultrasound showed that there were no significant differences in BF,BD,IMT,EDV and MFV between two groups (P ＞ 0.05).However the PSV and PI in concurrent diabetic foot group were significantly lower than those in non-concurrent diabetic foot group (P ＜ 0.05).The correlation analysis showed PSV was negatively correlated with HbA1 c(P ＜ 0.05),and PI was negatively correlated with HbA1 c,WBC and CRP (P ＜ 0.05).And the ROC curves of PSV and HbA1 c were drawn to compare the diagnostic efficacy of predicting the incidence of diabetic foot.The area under curve of PSV was 0.803,and sensitivity and specificity were 92.2％,62.7％,respectively,with critical point being 38.00cm/s.The area under curve of HbA1c was 0.621,and sensitivity and specificity was 83.1％,40.3％,respectively,with critical point being 6.93％.Conclusion The application of 18MHz high frequency color Doppler ultrasonography in community hospital helps to predict preferably the incidence of diabetic foot in patients with T2DM.