RESUMEN
Objective: To investigate the effect of hypertension on the process of carotid atherosclerotic lesions in patients with type 2 diabetes mellitus using ultrasound techniques. Methods: A total of 203 consecutive type 2 diabetic patients with hypertension were enrolled into the study. The patients were grouped according to the increased systolic blood pressure for 5 mm Hg as an observation unit. The hemodynamic parameters of intracranial and extracranial arteries in each group were measured by using color Doppler flow imaging (CDFI) and transcranial Doppler ultrasound (TCD) to identify the extent of vascular lesions. The correlations of systolic and diastolic blood pressure, age, hypertension, duration of diabetes with the detection rate of common carotid intimal medial thickness (CCA-IMT), carotid and intracranial arterial stenosis were analyzed. Results: Circled digit oneThe CCA-IMT in 203 patients was 0.62-1.36 mm (mean 1.04 ± 0.14 mm). The detection rate of intracranial arterial stenosis was 52.7%, in which the detection rate of stenosis rate ≥ 50% was 21.2%; the detection rate of extracranial carotid artery stenosis was 28.1%, in which the detection rate of stenosis rate ≥ 50% was 14.8%. The total detection rate of intracranial arterial stenosis and the detection rate of stenosis rate ≥ 50% were higher than extracranial carotid artery, in which there were significant differences in total detection rate of stenosis (P 0.05). Circled digit twoMultiple stepwise regression analysis showed that there was a linear relationship between the CCA-IMT and systolic blood pressure and age. For each increase of 5 mm Hg in systolic blood pressure, the CCA-IMT would increase 0.015 mm; for each increase of 1 year of age, the CCA-IMT would increase 0.008 mm. Circled digit threeThe total detection rate of intracranial artery stenosis showed a linear relationship with age. For each increase of 1 year of age, the total detection rate of stenosis increased 2.8%; the detection rate of ≥ 50% stenosis showed a linear relationship with systolic blood pressure. For each increase of 5 mm Hg in systolic blood pressure, the detection rate of stenosis increased 2%. Conclusion: the CCA-IMT increases with the increased blood pressure in hypertensive patients with type 2 diabetes. The progression of intracranial arterial stenosis in patients with diabetes mellitus promoted by hypertension is more apparent than carotid artery.
RESUMEN
Objective: To evaluate the effect of atorvastatin on the prevention of restenosis after vertebral artery origin stenting with color Doppler flow imaging (CDFI). Methods: A total of 59 patients with complete clinical data underwent unilateral vertebral artery origin stenting were recruited in the study. The patients were divided into drug (n =29) and non-drug (n =30) groups according to whether they took atorvastatin (20 mg/d) or not. All the patients were detected by CDFI before and at 1, 6, and 12 months after stenting. The peak systolic velocity (PSV) at the proximal (PSVOS) and intervertebral segments of vertebral artery (PSVIV) were recorded and the ratio of PSVOS/PSVIV was calculated. Digital subtraction angiography (DSA) showed that the in-stent stenosis rate ≥50% was determined as postoperative restenosis. The incidence of restenosis and hemodynamic changes were compared between the two groups. Results: Circled digit oneThe restenosis rates of the drug and non-drug groups at 6 months after stenting were 20.7% (6/29) and 36.7% (11/30) respectively (P >0.05); the restenosis rate (50.0%) of the non-drug group(50%) was significantly higher than that of the drug group (20.7%) at 12 months after stenting (P < 0.05). Circled digit twoThe PSV OS and PSVOS/PSVIV of the patients in both groups at 1 month after stenting were improved more significantly than those before the procedure. PSVOS(187±18 cm/s, 179±20 cm/s) and PSVOS/PSVIV(3.93±0.59, 3.24±0.48) were relatively increased in the non-drug group at 6 months after the procedure, but there was no significant difference. PSVOS (209±21 cm/s, 159±16cm/s) and PSVOS/PSVIV (4.34±0.65, 2.86±0.36) in the non-drug group at 12 months after stenting were significantly higher than those in the drug group. There was significant difference between the two groups (P < 0.05). Conclusions: Atorvastatin can decrease the restenosis rate after vertebral artery stenting. With the prolonged time of drug treatment, it may affect the hemodynamic changes in the abnormal vessels.