血清学指标联合CT血管成像诊断糖尿病足下肢动脉病变的临床价值  

Clinical Value of Serological Index Combined with CT Angiography in the Diagnosis of Diabetic Foot and Lower Extremity Arteriopathy

作　　者：黄玺[1] 吴玉文[2] 叶玲 HUANG Xi;WU Yu-wen;YE Ling(Department of Rheumatology and Immunology,Central South Hospital,Wuhan University,Wuhan 430071,Hubei Province,China;不详)

机构地区：[1]湖北省武汉大学中南医院风湿免疫科,湖北武汉430071 [2]湖北省武汉大学中南医院内分泌科,湖北武汉430071 [3]湖北省黄石市下陆区东方卫生服务中心,湖北黄石435004

出　　处：《中国CT和MRI杂志》2019年第12期126-128,共3页Chinese Journal of CT and MRI

摘　　要：目的分析血清学指标联合CT血管成像(CTA)诊断糖尿病足下肢动脉病变的临床价值。方法研究对象为本院自2014年1月-2018年6月收治的糖尿病足患者36例,回顾性分析其CTA、血清可溶性凝集素样氧化低密度脂蛋白受体1(sLOx-1)水平,与DSA对照,分析其s L O x-1联合C T A对糖尿病足下肢动脉病变的诊断价值。结果C T A诊断糖尿病足下肢血管狭窄(轻度+中重度狭窄)的敏感度为91.79%(246/268)、特异度91.50%(194/212)、准确率91.67%(440/480)、阳性预测值93.18%(246/264)、阴性预测值89.81%(194/216);不同下肢动脉血管病变程度患者间sLOx-1比较差异有统计学意义(P<0.05);且与下肢动脉血管病变程度显著正相关性(r=0.770,P<0.01);以106.198pg/mL为cut-off,sLOx-1预测糖尿病足下肢动脉血管病变的灵敏度为60.10%、特异度为98.30%,见表2、图1。与DSA对照,以106.198pg/mL为血清sLOx-1 cut-off,联合CTA诊断糖尿病足下肢动脉血管病变,其AUC曲线下面积值为0.963,对应敏感度及特异度分别为95.00%、100.00%。结论血清sLOx-1联合CTA可进一步提升CTA对糖尿病足下肢动脉血管病变的诊断效能,值得临床重视。Objective To analyze the clinical value of CT angiography(CTA)combined with serological indexes in the diagnosis of diabetic foot and lower limb arteriopathy.Methods thirty-six patients with diabetic foot admitted to our hospital from January 2014 to June 2018 were studied.The levels of CTA and serum soluble agglutinin-like oxidized low-density lipoprotein receptor 1(slox-1)were retrospectively analyzed and compared with DSA to analyze the diagnostic value of slox-1 combined with CTA in diabetic foot lower limb artery lesions.Results the sensitivity,specificity,accuracy,91.67%,positive predictive value,93.18%and negative predictive value were 91.79%(246/268),91.50%(194/212),91.67%(440/480),93.18%(246/264),and 89.81%(194/216)respectively.The difference in slox-1 between patients with different degrees of lower limb arterial lesions was statistically significant(P<0.05).There was a significant positive correlation with the degree of vascular lesions in the lower extremities(r=0.770,P<0.01).The sensitivity and specificity of 106.198pg/mL were 60.10% and 98.30%,respectively,as shown in table 2 and figure 1.;Compared with DSA,106.198pg/mL was used as serum slox-1 cut-off,and the area under the AUC curve was 0.963,and the corresponding sensitivity and specificity were 95.00% and 100.00%,respectively,when combined with CTA to diagnose diabetic foot lower extremity arterial lesions.Conclusion serum slox-1 combined with CTA can further improve the diagnostic efficacy of CTA in diabetic foot lower extremity arterial vascular diseases,which is worthy of clinical attention.

关 键 词：血清学指标 CT血管成像 糖尿病足 下肢动脉病变 

分 类 号：R587.1[医药卫生—内分泌]