本文選題：糖尿病2型 + 肩袖��； 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討應(yīng)用二維高頻超聲及能量多普勒技術(shù)評(píng)價(jià)2型糖尿病(T2DM)不同病程患者肩袖結(jié)構(gòu)形態(tài)學(xué)及血流異常改變的臨床價(jià)值。方法:收集60例T2DM患者,分為2組:病程≤10年(B組)30例;病程10年(C組)30例。另收集30名健康志愿者為正常對(duì)照(A組)。分別應(yīng)用二維高頻超聲及能量多普勒技術(shù)觀察3組雙側(cè)肩袖結(jié)構(gòu)各肌腱及肱二頭肌長(zhǎng)頭腱的回聲及血流情況,測(cè)量雙側(cè)岡上肌腱(SUP)、肩胛下肌腱(SUB)、岡下肌腱(INF)、肱二頭肌長(zhǎng)頭肌腱(BT)的厚度。結(jié)果:正常各肌腱長(zhǎng)軸均顯示為以纖細(xì)低回聲區(qū)所間隔的多個(gè)互相平行的細(xì)線樣強(qiáng)回聲的索條樣結(jié)構(gòu),在短軸切面則呈網(wǎng)狀結(jié)構(gòu);B組中岡上肌腱出現(xiàn)內(nèi)部回聲減低、回聲不均勻、肌腱邊緣不規(guī)則等內(nèi)部回聲異常的比率大于A組(P0.05),C組中岡上肌腱、肩胛下肌腱、岡下肌腱、肱二頭肌長(zhǎng)頭腱四組肌腱出現(xiàn)內(nèi)部回聲減低、不均勻、邊緣不規(guī)則等內(nèi)部回聲異常的比率較A組均增加(P均0.05);B組、C組各肌腱內(nèi)發(fā)現(xiàn)鈣化灶比率均大于A組(P均0.05);C組中肱二頭肌長(zhǎng)頭腱出現(xiàn)腱旁組織異常的比率大于A組(P0.05);雙側(cè)各肌腱中,B、C組與A組相對(duì)比厚度均增加,差異均有統(tǒng)計(jì)學(xué)意義(P均0.05);右側(cè)岡上肌腱、肱二頭肌長(zhǎng)頭腱兩組肌腱C組與B組之間相對(duì)比,肌腱厚度差異均有統(tǒng)計(jì)學(xué)意義(P均0.05);C組中肱二頭肌長(zhǎng)頭腱雙側(cè)厚度對(duì)比,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);A、B、C組中各肌腱內(nèi)可探及血流信號(hào)者為1級(jí)血流信號(hào)比率最高,各組間各級(jí)血流信號(hào)對(duì)比無(wú)顯著統(tǒng)計(jì)學(xué)差異。結(jié)論:利用二維高頻超聲技術(shù)能夠清晰顯示肩袖結(jié)構(gòu)各肌腱及其周圍組織的形態(tài)學(xué)改變,能夠發(fā)現(xiàn)T2DM患者隨病程增加,其肩袖結(jié)構(gòu)各肌腱更易出現(xiàn)肌腱內(nèi)部回聲局限或彌漫性減低、內(nèi)部回聲不均勻、肌腱邊緣不規(guī)則,肌腱內(nèi)鈣化灶或肌腱部分撕裂等改變,并且隨病程發(fā)展肌腱厚度逐漸增加。而PDI技術(shù)由于其對(duì)低速細(xì)小血流顯示較為敏感的特性,能夠顯示各肌腱內(nèi)部血流情況。因此,聯(lián)合使用二維高頻超聲及PDI技術(shù)能夠于T2DM患者出現(xiàn)臨床癥狀之前早期發(fā)現(xiàn)其肩袖結(jié)構(gòu)及周圍組織的異常增厚以及異�；芈暤雀淖�,可以為臨床早期診斷及治療T2DM患者肩袖病變提供重要的客觀依據(jù),在改善患者預(yù)后、提高患者生活質(zhì)量等方面具有重要的臨床意義。
[Abstract]:Objective: to evaluate the clinical value of two-dimensional high-frequency ultrasound and power Doppler technique in evaluating the morphological changes of rotator cuff structure and abnormal blood flow in patients with type 2 diabetes mellitus (T2DM).Methods: sixty patients with T2DM were divided into two groups: group B (30 cases) and group C (30 cases).Another 30 healthy volunteers were collected as control group A.The echo and blood flow of the tendons of bilateral rotator cuff structure and the long head tendon of biceps brachii were observed by two-dimensional high frequency ultrasound and energy Doppler technique.The thickness of bilateral supraspinatus tendons, subscapular tendons, infrascapular tendons, and long head tendons of biceps brachii were measured.Results: the long axis of normal tendons showed several parallel thin line like strong echo cable like structures separated by thin hypoechoic region. In the short axis section, the internal echo of supraspinatus tendon was decreased in group B, and in the short axis section, there was a decrease in the internal echo of the supraspinatus tendon in group B, and in the short axis section, there was a decrease in the internal echo of the supraspinar tendon.The rate of abnormal internal echo in group A was higher than that in group A (P 0.05). The rate of abnormal internal echo in group A was higher than that in group A (P 0.05). The internal echo of the tendon in group A was lower than that in group C (P 0.05), and the internal echo was not uniform in the four groups, including subscapular tendon, subscapular tendon, subscapular tendon and long head tendon of biceps brachii.The rate of abnormal internal echo in group A was higher than that in group A. The ratio of calcified lesions found in each tendon of group B was higher than that in group A and group C was higher than that of group A in group A. The rate of abnormal tendon in the long head of biceps brachii was higher than that in group A.Compared with group A, the thickness of both groups increased.There were significant differences in the thickness of tendon between group C and group B, there were significant differences in the thickness of tendon between group C and group B, there were significant differences in the thickness of tendon between group C and group B, and the thickness of the tendon of the long head of biceps brachii muscle in group C was significantly higher than that in group C (P < 0.05), and the thickness of tendon of long head of biceps brachii in group C was significantly higher than that in group B.The ratio of blood flow signal in each tendon was the highest in the group of P0.05A (P 0.05), but there was no significant difference in the comparison of blood flow signals among the groups.Conclusion: the morphological changes of tendon and surrounding tissues of rotator cuff structure can be clearly displayed by two-dimensional high-frequency ultrasound technique, and it can be found that the number of patients with T2DM increases with the course of disease.All tendons in the rotator cuff structure were more prone to the internal echo localization or diffuse decrease, uneven internal echo, irregular tendon edge, calcification focus or partial tear of tendon, and the thickness of tendon gradually increased with the course of disease.PDI can display the internal blood flow of each tendon because of its sensitivity to low velocity and small blood flow.Therefore, the combined use of two-dimensional high-frequency ultrasound and PDI can detect the abnormal thickening and echo of the rotator cuff structure and surrounding tissues before the onset of clinical symptoms in patients with T2DM.It can provide important objective basis for early diagnosis and treatment of rotator cuff disease in patients with T2DM. It has important clinical significance in improving the prognosis and quality of life of patients with T2DM.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.1;R587.2;R684

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相關(guān)期刊論文 前2條

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本文編號(hào)：1764196