踝臂指数、臂踝脉搏波传导速度及血清Meprin-α水平对2型糖尿病合并冠心病的诊断价值研究  

Diagnostic Value of ABI,ba PWV and Serum Meprin-α Level in Diagnosis of Type 2 Diabetes Mellitus Complicated with Coronary Heart Disease

作　　者：郜攀[1] 宋双双[1] 司良毅[1] 

机构地区：[1]中国人民解放军第三军医大学西南医院老年病科,重庆市400038

出　　处：《实用心脑肺血管病杂志》2015年第11期1-4,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：国家自然科学基金(81000132;81370007)

摘　　要：目的探讨踝臂指数(ABI)、臂踝脉搏波传导速度(ba PWV)及血清Meprin-α水平对2型糖尿病合并冠心病的诊断价值。方法选取2010—2013年中国人民解放军第三军医大学西南医院老年病科收治的单纯2型糖尿病患者92例(T2DM组),单纯冠心病患者153例(CHD组),2型糖尿病合并冠心病患者68例(T2DM-CHD组);另选取同期体检健康者150例作为对照组。检测各组受试者ABI、ba PWV及血清Meprin-α水平,并分析ABI、ba PWV及血清Meprin-α水平对冠心病及2型糖尿病合并冠心病的诊断价值。结果 T2DM组和T2DM-CHD组患者ABI低于对照组(P<0.05);T2DM组、CHD组及T2DM-CHD组患者ba PWV高于对照组,T2DM-CHD组患者ba PWV高于CHD组(P<0.05);T2DM组、CHD组及T2DM-CHD组患者血清Meprin-α水平高于对照组,T2DM组和T2DM-CHD组患者血清Meprin-α水平高于CHD组(P<0.05)。受试者工作特征曲线(ROC)曲线显示,ABI对冠心病无诊断价值(P>0.05),ba PWV对冠心病的诊断价值较高(AUC=0.973),血清Meprin-α水平对冠心病的诊断价值为中等(AUC=0.720)。ba PWV对2型糖尿病合并冠心病的诊断价值较高(AUC=0.940),当ba PWV≥1 936 cm/s时其诊断2型糖尿病合并冠心病的灵敏度为82.4%、特异度为96.7%;血清Meprin-α水平对2型糖尿病合并冠心病的诊断价值为中等(AUC=0.875),当血清Meprin-α水平≥2 314 ng/L时其诊断2型糖尿病合并冠心病的灵敏度为80.9%、特异度为92.4%。以冠状动脉造影作为诊断冠心病的金标准,ba PWV≥1 936 cm/s联合血清Meprin-α水平≥2 314 ng/L对2型糖尿病合并冠心病的诊断符合率为98.1%。结论 ABI与冠状动脉病变无明显相关性,ba PWV对2型糖尿病合并冠心病的诊断价值较高,血清Meprin-α水平对2型糖尿病合并冠心病的诊断价值为中等,ba PWV联合血清Meprin-α水平对2型糖尿病合并冠心病的诊断价值更高。Objective To analyze the diagnostic value of ABI,ba PWV and serum Meprin-α level in diagnosis of type2 diabetes mellitus complicated with coronary heart disease. Methods From 2010 to 2013 in the Department of Geriatrics,Southwest Hospital of the Third Military Medical University of Chinese People＇s Liberation Army,92 patients with isolated type 2diabetes mellitus were served as A group,153 patients with isolated coronary heart disease were served as B group,68 type 2diabetes mellitus patients complicated with coronary heart disease were served as C group,150 healthy cases were served as D group. ABI,ba PWV and serum Meprin-α level were detected,and their diagnostic value on coronary heart disease and type 2diabetes mellitus complicated with coronary heart disease was analyzed,respestively. Results ABI of A group,C group was statistically significantly lower than that of D group, respectively（ P 〈0. 05）; ba PWV of A group, B group, C group was statistically significantly higher than that of D group,respectively,and ba PWV of C group was statistically significantly higher than that of B group（ P 〈0. 05）; serum Meprin-α level of A group,B group,C group was statistically significantly higher than that of D group,respectively,and serum Meprin-α level of A group,C group was statistically significantly higher than that of B group,respectively（ P 〈0. 05） .ROC curve showed that,ABI had no diagnostic value on coronary heart disease（ P 0. 05）,while ba PWV had relatively high diagnostic value on coronary heart disease（ AUC = 0. 973）,serum Meprin-α level had medium diagnostic value on coronary heart disease（ AUC = 0. 720）. ba PWV had relatively high diagnostic value on type 2 diabetes mellitus complicated with coronary heart disease（ AUC = 0. 940）,when it was equal or over 1 936 cm / s,the sensitivity was82. 4%,the specificity was 96. 7%; serum Meprin-α level had medium diagnostic value on type 2 diabetes mellitus complicated with coronary heart disease（ AUC = 0. 875）,when it was

关 键 词：糖尿病 2型 冠心病 踝臂指数 臂踝脉搏波传导速度 Meprin-α 诊断 

分 类 号：R587.1[医药卫生—内分泌] R541.4[医药卫生—内科学]