Predictive value of carotid artery ultrasound quantitative examination for stroke in patients with diabetes mellitus type 2 complicated with hypertension

ZHANG Shiming; WANG Xia; WU Jinqiao

doi:10.20258/j.cnki.1006-9011.2025.06.004

Abstract：Objective To explore the clinical significance of carotid artery ultrasound quantitative exmination forstroke in pa-tients with diabetes mellitus type 2(T2DM)complicated with hypertension(HTN).Methods A total of 122 patients with T2DM combined with HTN were selected and divided into stroke group(n=15)and no stroke group(n=107)according to whether they had stroke in the past 3 years.Clinical data,carotid ultrasound quantitative parameters,i.e.,common carotid ar-tery,carotid artery crossing and internal carotid artery intima-media thickness(IMT),end-diastolic blood flow velocity(EDV),resistance index(RI),peak systolic blood flow velocity(PSV),and pulse index(PI),were compared between the two groups.Logistic regression analysis was conducted to analyze the influencing factors of stroke occurrence in T2DM patients complicated with HTN,and the correlation between carotid artery ultrasound quantitative parameters and carotid atherosclerosis and lowden-sity lipoprotein cholesterol(LDL-C)was analyzed.ROC curve and DCA curve were plotted to evaluate the predictive value of ca-rotid artery ultrasound quantitative parameters on stroke occurrence in patients.Results The proportion of carotid atherosclero-sis and LDL-C in stroke group were higher than those in non-stroke group(all P<0.05).The IMT of common carotid artery,in-tersections of carotid artery and internal carotid artery in stroke group were higher than those in no stroke group,the PSV and EDV of carotid artery were lower than those in no stroke group,and the PI and RI were higher than those in no stroke group(all P<0.05).Carotid atherosclerosis,LDL-C,common carotid artery,intersection of carotid artery and internal carotid artery IMT,PSV,EDV,PI and RI were all influencing factors for stroke occurrence in T2DM patients with HTN(all P<0.05).Common ca-rotid artery,intersection of carotid artery and internal carotid artery IMT,PI and RI were positively correlated with carotid ath-erosclerosis and LDL-C,while PSV and EDV were negatively correlated with carotid atherosclerosis and LDL-C(all P<0.05).The predictive efficacy and clinical net benefit rate of carotid IMT combined with hemodynamic indexes in predicting stroke oc-currence in T2DM patients with HTN were greater than those of carotid IMT and hemodynamic indexes.Conclusion Carotid IMT and hemodynamic abnormalities are present in patients with T2DM combined with HTN,and these abnormalities can in-crease the risk of stroke.The predictive value of ultrasound quantitative parameters combine with hemodynamic indicators is well for the occurrence of stroke in patient with T2DM complicated with HTN.