UKPDS评分联合颈动脉超声预测2型糖尿病患者冠状动脉病变程度的临床应用  

UKPDS score combined with carotid ultrasonography in predicting severity of coronary artery lesions of patients with type 2 diabetes mellitus

作　　者：吴妍 何浪 刘小慧 许峥贵 王丹 付蕾 沈法荣 WU Yan;HE Lang;LIU Xiaohui;XU Zhenggui;WANG Dan;FU Lei;SHEN Farong(Department of Endocrinology,Zhejiang Greentown Cardiovascular Hospital,Hangzhou 310012,China)

机构地区：[1]浙江绿城心血管病医院内分泌科,杭州310012 [2]浙江绿城心血管病医院心内科,杭州310012

出　　处：《浙江医学》2020年第20期2152-2155,共4页Zhejiang Medical Journal

基　　金：浙江省医药卫生科研基金(2017ky561)。

摘　　要：目的探讨英国前瞻性糖尿病研究(UKPDS)评分联合颈动脉超声预测2型糖尿病(T2DM)患者冠状动脉病变程度的可能性及准确性并建立预测模型。方法选取2012年1月至2016年12月在浙江绿城心血管病医院住院的496例T2DM并行冠状动脉造影患者的临床资料,使用UKPDS评分评估10年冠心病风险(CHDRISK),按冠状动脉造影结果计算SYNTAX评分,根据评分结果分为低分组(<23分)304例和中高分组(≥23分)192例。logistic回归分析与冠状动脉病变程度相关的因素;并建立预测模型,采用ROC曲线评价模型的预测效能。结果两组患者在女性比例、吸烟史、糖尿病病程、FPG、TC、TG、颈动脉硬化、CHDRISK、SYNTAX评分方面比较差异均有统计学意义(均P<0.05);logistic回归分析结果显示CHDRISK和颈动脉硬化与STNTAX中高分均存在显著相关(均P<0.05);预测模型AUC=0.626,即预测准确率为62.6%。结论UKPDS评分及颈动脉硬化与T2DM患者冠状动脉的病变程度显著相关,由此建立的预测模型有较好的预测价值,适用于无法开展冠状动脉CT血管造影和冠状动脉造影的基层单位进行初步筛查。Objective To evaluate the application of United Kingdom Prospective Diabetes Study(UKPDS)score combined with carotid ultrasound findings to predict the severity of coronary artery disease in patients with type 2 diabetes mellitus(T2DM).Methods Clinical data of 496 T2DM patients with concurrent coronary angiography admitted to Zhejiang Greentown Cardiovascular Hospital from January 2012 to December 2016 were retrospectively analyzed.The 10-year risk of cardiovascular disease was assessed by UKPDS score,and SYNTAX score was calculated according to the coronary angiography.According to the score,the patients were divided into 304 cases in the low piont group(<23 points)and 192 cases in the media-high point group(≥23 points).The factors related to the coronary artery lesion severity was examined by regression analysis,and a prediction model was established.ROC curve was used to evaluate the prediction efficacy of the model.Results here were statistically significant differences between the two groups in female proportion,smoking rate,diabetic duration,fasting blood glucose,total cholesterol,total triglyceride,incidence of carotid atherosclerosis,CHDRISK and SYNTAX score(all P<0.05)Logisticregressionanalysis results showedthat there was significant correlation between CHDRISK,carotidatherosclerosis and media-high STNTAX score(all P<0.05).The prediction model AUC=0.626,that is,the prediction accuracy is 62.6%.Conclusion KPDS score and carotid atherosclerosis are significantly correlated with the degree of coronary artery lesions in patients with T2DM.The predictive model established thereby has good predictive value and is suitable for primary screening in primary units that cannot carry out coronary CT angiography or coronary angiography.

关 键 词：糖尿病 心血管病风险 冠心病 预测模型 

分 类 号：R541.4[医药卫生—心血管疾病] R587.2[医药卫生—内科学]