最大颈动脉内膜中层厚度对2型糖尿病伴冠心病的预测作用  

Maximum Carotid Intima-Media Thickness for Predicting Coronary Artery Disease in Type 2 Diabetic Patients

作　　者：洪澍彬[1] 郑艳玲[2] 曹筱佩[1] 修玲玲[1] 廖志红[1] 李延兵[1] 肖海鹏[1] 

机构地区：[1]中山大学附属第一医院内分泌科,广东广州510080 [2]中山大学附属第一医院超声科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2013年第5期739-743,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2010B031600062)

摘　　要：[目的]探讨最大颈动脉内膜中层厚度（cIMT）对2型糖尿病（T2DM）伴冠心病（CAD）的诊断预测作用.[方法]将98例T2DM患者根据有无伴CAD分为CAD组48例和无CAD组50例,测量最大cIMT以及各项临床和实验室指标.[结果]CAD组中最大cIMT高于无CAD组[1.30 mm （1.13,1.40） vs.1.00 mm （0.80,1.20）,P＜ 0.001].多因素logistic回归分析显示,经心血管风险因素校正后,最大cIMT仍与T2DM伴CAD相关（OR=3.135,95％ CI 1.501～6.549,P=0.001）,是T2DM伴CAD的独立预测因素.受试者工作特征曲线显示最大cIMT对T2DM伴CAD的诊断切点为1.15 mm,其敏感性为75％、特异性为70％.[结论]最大cIMT是T2DM伴CAD的独立预测因素,具有较高诊断敏感性与特异性,可作为T2DM伴CAD的一个简便、无创、有效的诊断预测指标.[Objective] To evaluate the value of maximum carotid intima-media thickness （cIMT） for predicting coronary artery disease （CAD） in the patients with type 2 diabetes mellitus （T2DM）. [Methods] Ninety-eight patients with T2DM were divided into CAD group （n = 48） and non-CAD group （n = 50）. Maximum cIMT, clinical and laboratory data were assessed. [ Results ] Maximum cIMT was significantly higher in CAD group than that in non-CAD group [ 1.30 mm （1.13, 1.40） vs 1.00 mm （0.80, 1.20）,P 〈 0.001]. Multivariate logistic regression analysis revealed that maximum clMT was associated with CAD after adjusting for cardiovascular risk factors （OR = 3.135, 95%CI 1.501 - 6.549, P〈 0.001）, which was an independent predictor of T2DM with CAD. ROC curve showed the cut-off level of maximum cIMT for screening CAD was 1.15 mm. When maximum clMT was larger than 1.15 mm, the diagnostic sensitivity and specificity were 75% and 70%, respectively. [ Conclusion ] Maximum cIMT is an independent predictor of T2DM with CAD. It has a decent diagnostic sensitivity and specificity on predicting T2DM with CAD. Maximum cIMT could be used as a simple, noninvasive and useful marker for prediction of CAD in type 2 diabetic patients.

关 键 词：颈动脉内膜中层厚度 2型糖尿病 冠心病 

分 类 号：R587.1[医药卫生—内分泌]