血清MMP-1、BNP、TIMP2水平变化用于糖尿病心肌病早期诊断的价值研究  

Serum levels of MMP-1, BNP and TIMP2 in early diagnosis of diabetic cardiomyopathy

作　　者：许士达 宋丽 邢海燕[1] Xu Shida;Song Li;Xing Haiyan(Dezhou People's Hospital, Dezhou 253014, China)

机构地区：[1]德州市人民医院,253014

出　　处：《国际医药卫生导报》2019年第5期747-750,共4页International Medicine and Health Guidance News

摘　　要：目的探讨血清基质金属蛋白酶-1(MMP-1)、脑钠肽(BNP)、基质金属蛋白酶组织抑制因子2(TIMP2)的变化对糖尿病心肌病的诊断价值。方法选取本院2018年3月至2018年9月确诊的50例糖尿病心肌病患者(心肌病组)、50例单纯2型糖尿病患者(糖尿病组),检测两组患者的血清MMP-1、BNP、TIMP2水平,采用超声心动图测定两组的左室射血分数(EF%)、左室短轴缩短率(FS%)、二尖瓣口舒张期E峰速度/A峰速度(E/A);并绘制ROC曲线分析3项指标对于鉴别诊断糖尿病心肌病的价值。结果心肌病组患者血清MMP-1、BNP、TIMP2水平分别为(35.91±4.20)μg/L、(5.19±0.72)pg/ml、(486.9±98.7)μg/L,均高于糖尿病组(30.26±3.84)μg/L、(4.50±0.60)pg/ml、(258.5±84.0)μg/L,差异均有统计学意义(均P<0.05);心肌病组患者EF%、E/A值分别为(60.52±3.28)%、(1.130±0.114),均低于糖尿病组(62.91±3.67)%、(1.199±0.133),差异均有统计学意义(均P<0.05);心肌病组患者FS%与糖尿病组比较,差异无统计学意义(P>0.05);血清MMP-1、BNP、TIMP2水平联合检测鉴别诊断糖尿病心肌病的灵敏度为95.81%、特异度为90.05%、漏诊率为4.19%、误诊率为9.95%、ROC曲线下面积AUC值为0.921。结论糖尿病心肌病患者血清MMP-1、BNP、TIMP2水平较单纯2型糖尿病患者升高更加显著,三者联合检测对于早期发现患者心肌损害具有一定的价值。Objective To explore the value serum levels of matrix metalloproteinase-1 (MMP-1), brain natriuretic peptide (BNP), and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) in the diagnosis of diabetic cardiomyopathy. Methods The serum levels of MMP-1, BNP and TIMP2 were measured in 50 patients with diabetic cardiomyopathy (cardiomyopathy group) and 50 patients with type 2 diabetes mellitus (diabetes group) who were diagnosed at our hospital from March to September, 2018. The left ventricular ejection fraction (EF%), left ventricular short axis shortening rate (FS%), and mitral diastolic E/A peak velocity (E/A) were measured by echocardiography in the two groups;and the ROC curve was drawn to analyze the value of the three indicators in the differential diagnosis of diabetic cardiomyopathy. Results The serum levels of MMP-1, BNP, and TIMP- 2 in the patients with cardiomyopathy were(35.91±4.20)μg/L,(5.19±0.72)pg/ml, and (486.9±98.7)μg/ L, respectively, which were significantly higher than those in the patients with diabetes mellitus [(30.26±3.84)μg/L,(4.50±0.60)pg/ml, and (258.5±84.0)μg/L](all P < 0.05). The EF% and E/A of the patients with cardiomyopathy were (60.52±3.28)% and(1.130±0.114)respectively, which were significantly lower than those of the patients with diabetes mellitus [(62.91±3.67)% and(1.199±0.133)](both P < 0.05). The FS% in the patients with cardiomyopathy was not significantly different from that in the patients with diabetes mellitus (P > 0.05). The sensitivity, specificity, missed diagnosis rate, misdiagnosis rate, and AUC value under ROC curve were 95.81%, 90.05%, 4.19%, 9.95%, and 0.921, respectively. Conclusions The serum levels of MMP-1, BNP and TIMP2 in patients with diabetic cardiomyopathy are significantly higher than those in patients with type 2 diabetes mellitus. The combined detection of MMP-1, BNP, and TIMP2 has certain value for early detection of myocardial damage in patients with diabetic cardiomyopathy.

关 键 词：基质金属蛋白酶-1 脑钠肽 基质金属蛋白酶组织抑制因子2 糖尿病 心肌病 

分 类 号：R587.2[医药卫生—内分泌]