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目的观察病程对Ⅱ型糖尿病患者不同部位皮肤厚度的影响。方法选取住院的Ⅱ型糖尿病患者346例,及非糖尿病对照组(C)102例,按病程长短分为初发组(E)84例、短病程组(S)148例、长病程组(L)114例。利用超声皮肤成像技术测量患者胸壁及下肢远端皮肤厚度,比较4组患者皮肤厚度差异及变化趋势。结果不同病程的糖尿病E、S、L组与非糖尿病C组之间,皮肤厚度存在显著差异,差异有统计学意义(P<0.05)。检测部位不同,皮肤厚度随病程变化的趋势也不同,E、S、L组患者的胸壁皮肤均厚于非糖尿病C组(P<0.05);而对于下肢远端,当病程超过1年时,糖尿病患者内踝区皮肤开始变薄,病程超过10年后,内外踝区皮肤均明显变薄(P<0.05)。结论超声可用于无创性评估Ⅱ型糖尿病患者的皮肤厚度。胸壁处皮肤在患糖尿病后即开始增厚;而下肢远端皮肤则在病程超过10年时明显变薄。
Objective To observe the effect of disease course on the skin thickness of different parts of type Ⅱ diabetic patients. Methods A total of 346 inpatients with type 2 diabetes mellitus and 102 in non-diabetic control group (C) were enrolled. According to the duration of the disease, 84 cases were divided into initial group (E), 148 cases with short course (S), 148 cases with long course ) 114 cases. Ultrasound skin imaging technique was used to measure the thickness of the distal skin of the chest wall and lower extremity. The differences of skin thickness and the changing trend of the four groups were compared. Results There was a significant difference in skin thickness between groups E, S, L and non-diabetic C at different stages of disease, the difference was statistically significant (P <0.05). In different sites, the thickness of the skin changes with the course of the disease is also different, E, S, L patients with chest wall thicker than non-diabetic group C (P <0.05); while for the distal lower extremity, when the course of more than 1 year, The skin of the medial malleolus in diabetic patients began to thin. After more than 10 years of course, the skin of the medial and lateral ankle areas became thinner (P <0.05). Conclusion Ultrasound can be used to noninvasively assess skin thickness in patients with type 2 diabetes. Chest wall at the beginning of the skin after the onset of diabetes thickening; while the lower extremity of the skin in the course of more than 10 years significantly thinning.