Background: To identify opportunities for Doppler ultrasound in the diagnosis of cerebral microangiopathy in patients with diabetes mellitus type 2 and hypertension.
Methods: The study included the diagnosis of 72 patients with type 2 diabetes and hypertension who were hospitalized in the 2 and 3 clinics TMA. The control group consisted of 25 patients aged 61.9 ± 2.6 years, suffering from type 2 diabetes. The study group included 47 patients (19 men and 28 women), older age groups with diagnosed type 2 diabetes and hypertension history, besides the patients of the second group were divided into two groups - those with diabetes complications flow - 23 patients without microvascular complications - 24 patients. Time monitoring of patients ranged from 3 to 8 years. All patients underwent Doppler ultrasound of the main arteries of the head and neck - the internal carotid artery. Evaluated the speed of blood flow indices, the PI index (which determines the stiffness and elasticity of the arteries), the RI index (reflecting peripheral resistance), systolic and diastolic index (the ISD), assessed cerebrovascular reactivity (according to tests with breath-holding and hyperventilation).
Results: Changes dopplerographic index in the BCA were observed in 19 patients in the subgroup with diabetes complications compared with 2 patients of the subgroup without complications. In the subgroup with diabetes complications 21 patients had signs of nephropathy and in 18 of them were identified changes in dopplerographic indicators BCA, which may indicate vascular remodeling processes in the body of patients with type 2 diabetes. Significant moderate and strong correlation LED current duration of type 2 and the presence of diabetic retinopathy and nephropathy, altered dopplerographic indices PI and RI. So a critical increase in the ICA RI index was observed after 6.8 years after the diagnosis of type 2 diabetes. It was revealed that the predictors of microcirculatory disorders in patients with type 2 diabetes mellitus were the duration of 8 years. It is shown that microcirculatory disorders, diagnosed by means of ultrasound diagnostics, develop an average of 7 years after the onset of diabetes. Changes in dopplerographic indices were observed mainly in patients with type 2 diabetes complications. At the same time in all patients with a diabetes study group for the duration of 2 years, more than 7 marked changes in cerebrovascular reactivity by reducing vasodilatation reserve.
Conclusions: These results suggest that Doppler ultrasound diagnoses cerebral microangiopathy in patients with type 2 diabetes.
21 May 2022 - 24 May 2022