糖尿病足患者下肢血管造影特点及其临床意义Angiographic characteristics of lower extremities in diabetic foot patients
张海涛,柴萌,罗惠兰,黄丛春,谈维洁,朴龙松,齐自荣,王俊华,于心亚,刘朝中
摘要(Abstract)：
目的探讨糖尿病足下肢动脉的血管造影成像特点,并分析其临床意义。方法分析糖尿病足患者35条患肢的造影结果,分别对下肢缺血病变不同临床分期、不同部位的血管狭窄程度进行比较,并进行统计学分析。结果(1)以管腔狭窄程度<50%为0分,50%~74%为1分,75%~99%为2分,管腔完全闭塞者为3分。膝以上与膝以下共210个动脉节段比较,两组血管的狭窄程度为0,1,2,3分的分别是32.9%比18.5%,20.0%比9.3%,12.9%比14.3%,34.2%比57.9%,差异均有统计学意义(P均<0.05)。膝以上血管以轻中度狭窄为主,膝以下血管则以重度乃至完全闭塞病变为主。(2)每侧患肢腓动脉重度狭窄的几率(57.1%)明显低于胫前(77.1%)和胫后动脉(74.3%)。(3)间歇性跛行患肢膝以下三叉血管系统重度狭窄率41.7%,与静息痛(83.3%)或溃疡(79.5%)患肢相比,差异均有统计学意义(P均<0.05)。结论临床出现静息痛、溃疡及坏疽时,表明膝以下血管出现广泛重度病变,且多为三支血管联合病变。糖尿病足患者血管病变大多累及下肢远段小血管,其双侧动脉病变多为对称性同步发展。腓动脉在糖尿病性动脉硬化发病过程中病变较轻,为膝以下小动脉搭桥提供了良好的流出道。
关键词(KeyWords)： 糖尿病足;下肢;血管造影术
基金项目(Foundation):
作者(Author): 张海涛,柴萌,罗惠兰,黄丛春,谈维洁,朴龙松,齐自荣,王俊华,于心亚,刘朝中
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