2型糖尿病对急性ST段抬高型心肌梗死患者血清可溶性晚期糖基化终产物受体水平的影响  

The variation of the serum levels of soluble receptor of advanced glycation end products in patients with acute ST-segment elevation myocardial infarction when Accompanied by type 2 diabetes mellitus

作　　者：杨瑞玲[1] 李丽燕[1] 赵旭东[1] 李平静[1] 

机构地区：[1]徐州医学院附属医院老年医学科,江苏省徐州市221006

出　　处：《中国心血管病研究》2016年第10期899-904,共6页Chinese Journal of Cardiovascular Research

摘　　要：目的 观察2型糖尿病（T2DM）伴急性ST段抬高型心肌梗死（STEMI）患者血清可溶性晚期糖基化终产物受体（sRAGE）水平的变化.方法 选择60例STEMI患者,其中伴T2DM者为Ⅰ组,无糖尿病者为Ⅱ组,每组30例;并选取30例T2DM无并发症者为Ⅲ组;选取30名健康体检者为Ⅳ组.受试者均测定血清sRAGE及心肌肌钙蛋白（cTnI）水平.结果 sRAGE水平Ⅰ组为（1149.0±188.6）ng/L,Ⅱ组为（926.6±165.4）ng/L,Ⅲ组为（509.4±78.9）ng/L,Ⅳ组为（696.8±101.8）ng/L,两两比较任意两组间比较差异均有统计学意义（P=0.000）;cTnI水平Ⅰ组为（4.84±8.39） μg/L,Ⅱ组为（2.86±4.37）μg/L,Ⅲ组为（0.01±0.01）μg/L,Ⅳ组为（0.01±0.01）μg/L;sRAGE曲线下面积（AUCaRAGE）为0.967±0.014（P=0.000,95％CI 0.940～0.994）.AUCcTnI为0.875（P=0.000,95％CI 0.807～0.944）.sRAGE截断点取761.550 ng/L时,灵敏度（Se）为91.7％,特异度（Sp）为83.0％,约登指数（YI）为83.4％;cTnI截断点取0.060 μg/L时,Se为76.7％,Sp为98.3％,YI为75.0％.结论 急性ST段抬高型心肌梗死伴2型糖尿病患者血清sRAGE水平增高.sRAGE对急性ST段抬高型心肌梗死可能有早期诊断价值.Objective To observe the variation of the serum levels of soluble receptor for advanced glycation end products （sRAGE） in patients with acute ST-segment elevation myocardial infarction （STEMI） when Accompanied by type 2 diabetes mellitus （T2DM）, analyze the mechanism, and to explore the diagnosis value of sRAGE to STEMI. Methods 60 patients with STEMI were selected and divided into two groups with equal individuals ： the cases in group Ⅰ were accompanied by T2DM, while group Ⅱ without T2DM. group Ⅲ was composed of 30 T2DM patients without complications and group IV was composed of 30 healthy people. Both serum sRAGE and cardiac troponin Ⅰ（cTnI） levels were determined. Results Serum level of sRAGE was（ 1149.0±188.6）ng/L in group Ⅰ , and （926.6±165.4）ng/L in group Ⅱ , and （509.4±78.9）ng/L in group Ⅲ, and （696.8±101.8）ng/L in group Ⅳ. The differences were statistically significant （P=0.000）. Serum level of cTnI was （4.84±8.39）μg/L in group Ⅰ, and （2.86±4.37）μg/L in group Ⅱ, and （0.01±0.0I）μg/L in groupⅢ, and （0.01±0.01）μg/L in group Ⅳ. The area under the curve of sRAGE （AUC sRAGE） was 0.967±0.014 （P=0.000, 95%CI 0.940-0.994）, while AUC cTnI was 0.875 （P=0.000, 95%CI 0.807-0.944）. When the cut-off point of sRAGE was 761.550 ng/L, the diagnostic sensitivity（Se） was 91.7%, and specificity（Sp） was 83.0%, and Youden index（YI） was 83.4%, while the cut-off point of cTnI was 0.060 μg/L, Se was 76.7%, and Sp was 98.3%, YI was 75.0%. Conclusion The serum levels of sRAGE in patients with acute ST-segment elevation myocardial infarction Accompanied by type 2 diabetes mellitus were elevated. And sRAGE may have earlier diagnostic value on acute ST segment eleva- tion myocardial infarction.

关 键 词：2型糖尿病 急性ST段抬高型心肌梗死 可溶性晚期糖基化终产物受体 肌钙蛋白 

分 类 号：R542.22[医药卫生—心血管疾病]