踝肱指数联合震动感觉阈值检测2型糖尿病合并下肢动脉粥样硬化疾病的诊断价值分析  

Diagnostic Value of Ankle-brachial Index Combined with Vibrating Perception Threshold in Type 2 Diabetes Mellitus Complicated with Lower Extremity Atherosclerotic Disease

作　　者：罗灵光 龙新平 韩志蓉 LUO Lingguang;LONG Xinping(Laibin People＇s Hospital of Guangxi Zhuang Autonomous Region,Guangxi Laibin 546100,China)

机构地区：[1]广西壮族自治区来宾市人民医院内分泌科,广西来宾546100 [2]四川省广元市中心医院,四川广元628000

出　　处：《河北医学》2018年第11期1824-1829,共6页Hebei Medicine

基　　金：四川省卫生厅科研基金项目;(编号:150139)

摘　　要：目的:探讨踝肱指数联合震动感觉阈值检测2型糖尿病合并下肢动脉粥样硬化疾病的诊断价值。方法:选择2型糖尿病合并下肢动脉粥样硬化疾病患者119例,随机分为对照组(ABI≥0.9且VPT≤10 V) 56例以及观察组63例(ABI <0.9且VPT> 10V),测定ABI、VPT、TC、TG、HDL-C、LDL-C、FBG、HbA1c、尿酸、ALB水平。结果:观察组ABI水平低于对照组,VPT水平高于对照组(t=13.45、14.67,P <0.05);观察组LDL-C水平高于对照组(t=15.32,P <0.05);观察组尿酸水平明显高于对照组(t=15.67,P <0.05); ABI与年龄、病程、LDL-C、尿酸负相关关系明显,VPT与年龄、病程、LDL-C、尿酸正相关关系明显(P<0.05);年龄、病程、LDL-C、尿酸均为2型糖尿病合并下肢动脉粥样硬化疾病发生的危险因素(回归系数=1.43、1.61、1.71、1.45,P<0.05);以ABI≤0.9为诊断2型糖尿病合并下肢动脉粥样硬化疾病的金标准,以VPT>10V为诊断标准,灵敏度为75.9%、特异度为84.8%、假阴性率为24.0%、假阳性率为15.2%、正确指数为0.61、阳性似然比为4.99、阴性似然比为0.28,行Kappa一致性分析,其值为0.60。结论:2型糖尿病患者合并下肢动脉粥样硬化疾病踝肱指数降低、震动感觉阈值升高,其与危险因素年龄、病程、LDL-C、尿酸密切相关;震动感觉阈值诊断2型糖尿病合并下肢动脉粥样硬化疾病与踝肱指数诊断具有中、高一致性,值得在临床上推广应用。Objective： To explore the diagnostic value of ankle brachial index （ABI） combined with vibration perception threshold （VPT） in type 2 diabetes mellitus （DM） complicated with lower extremity atherosclerotic disease. Methods： A total of 119 type 2 diabetes mellitus patients with PAD were selected and randomly divided into two control group （ABI≥0.9, VPT≤10 V） 56 cases and observation group （ABI〈0.9,VPT〉10V） 63 cases. The ABI was detected by ultrasonic flow meter, and The VPT was detected by digital vibration perception threshold detector,and the levels of TC, TG, HDL-C, LDL-C, FBG, HbA1c, uric acidand ALB were detected by automatic biochemical analyzer. Results： The level of ABI in the observation groupwas lower than that in the control group, and the VPT level was higher in the observation group than that inthe control group （t = 13.45, 14.67, P〈0.05）, The level of LDL-C in the observation group was higher thanthat in the control group （t = 15.32, P〈0.05）, The level of uric acid in the observation group was higher thanthat in the control group （t = 15.67, P〈0.05）, The age, course of disease, LDL-C and uric acid were negatively correlated with ABI and positively correlated with VPT, with statistic difference （P〈0.05）, Age, duration of disease, LDL-C, and uric acid were risk factors for type 2 diabetes mellitus with LEAD （regression coefficients = 1.43, 1.61, 1.71, 1.45, P〈0.05）,ABI ≤ 0.9 is the gold standard for the diagnosis of type 2 diabetes mellitus combined with lower extremity atherosclerotic disease. The diagnostic criteria are VPT〉10 V,sensitivity is 75.9%, specificity is 84.8%, false negative rate is 24.0%, false positive rate 15.2%, correct index 0.61, positive likelihood ratio 4.99, negative likelihood ratio 0.28, Kappa consistency analysis, value is0.60. Conclusion： In type 2 diabetic patients with lower extremity atherosclerotic disease, ankle brachial index decreased and vibration perception threshold increased, which were closely r

关 键 词：2型糖尿病 踝肱指数 震动感觉阈值 下肢动脉粥样硬化疾病 

分 类 号：R587.2[医药卫生—内分泌]