老年2型糖尿病大血管病变患者颈动脉IMT与血浆Hcy、IL-17、NGAL表达的关系  

The relationship between IMT in the carotid artery and the expression of plasma Hcy,IL-17,NGAL in elderly patients with type 2 diabetes mellitus and macrovascular disease

作　　者：周海侠 方开峰[1] 朱军[1] ZHOU Hai-xia;FANG Kai-feng;ZHU Jun(Department of Ultrasound, General Hospital of Anhui Wanbei Coal and Electricity Group, Anhui Province, Suzhou 234000, China)

机构地区：[1]皖北煤电集团总医院超声科,安徽宿州234000

出　　处：《河北医科大学学报》2022年第5期608-613,共6页Journal of Hebei Medical University

基　　金：蚌埠医学院自然科学类项目(BYKY2019248ZD)。

摘　　要：目的探讨老年2型糖尿病(type 2 diabetes mellitus,T2DM)大血管病变患者颈动脉内膜中层厚度(intima-media thickness,IMT)与血浆同型半胱氨酸(homocysteine,Hcy)、白细胞介素17(interleukin-17,IL-17)、中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)表达的关系。方法选取老年T2DM大血管病变患者92例作为观察组,另选取不伴有大血管病变老年T2DM患者92例作为对照组。比较2组临床资料、颈动脉IMT、Hcy、IL-17、NGAL水平,分析老年T2DM大血管病变发病影响因素、颈动脉IMT与Hcy、IL-17、NGAL水平相关性及颈动脉IMT、Hcy、IL-17、NGAL水平对老年T2DM大血管病变的诊断价值,并对比联合诊断阳性、阴性患者预后情况。结果观察组三酰甘油(triacylglycerol,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)及颈动脉IMT、Hcy、IL-17、NGAL水平均高于对照组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,TG、LDL-C颈动脉IMT、Hcy、IL-17、NGAL水平均为老年T2DM大血管病变发病的影响因素(P<0.05)。老年T2DM大血管病变患者颈动脉IMT与Hcy、IL-17、NGAL水平均呈正相关(P<0.05)。颈动脉IMT、Hcy、IL-17、NGAL水平联合诊断老年T2DM大血管病变的AUC最大,为0.951,具有良好诊断效能。联合诊断阳性患者躯体健康、躯体角色功能、躯体疼痛及总体健康评分均低于阴性患者,差异有统计学意义(P<0.05)。结论老年T2DM大血管病变患者颈动脉IMT与血浆Hcy、IL-17、NGAL表达有关,各指标可效诊断大血管病变,利于临床诊治。Objective To investigate the relationship between the carotid intima media thickness(IMT)and the expression of plasma homocysteine(Hcy),interleukin-17(IL-17),neutrophil gelatinase-associated lipocalin(NGAL)in elderly patients with type 2 diabetes mellitus(T2DM)and macrovascular disease.Methods In total,92 elderly T2DM patients with macrovascular disease in our hospital were selected as the observation group,and 92 elderly T2DM patients without macrovascular disease were selected as the control group.The clinical data,carotid IMT,Hcy,IL-17 and NGAL levels were compared between two groups.The factors influencing the pathogenesis of T2DM and macrovascular disease in the elderly,the correlation between carotid IMT and Hcy,IL-17,NGAL levels,and the diagnostic value of carotid IMT,Hcy,IL-17,NGAL levels in the diagnosis of T2DM and macrovascular disease in the elderly patients were analyzed.The prognosis of patients with positive and negative disease by combined diagnosis was compared.Results The levels of triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C)and carotid IMT,Hcy,IL-17 and NGAL in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Logistic regression analysis showed that the levels of carotid IMT,Hcy,IL-17,and NGAL were all influential factors in the pathogenesis of T2DM and macrovascular disease in the elderly patients(P<0.05).The carotid IMT of the elderly patients with T2DM and macrovascular disease was positively correlated with Hcy,IL-17 and NGAL levels(P<0.05).The area under ROC curve(AUC)of the elderly T2DM patients with macrovascular disease diagnosed by carotid IMT,Hcy,IL-17,and NGAL levels was the largest,which was 0.951,suggesting good diagnostic efficiency.The physical health,physical role function,physical pain and overall health scores of positive patients by combined diagnosis were lower than those of negative patients,and the difference was statistically significant(P<0.05).Conclusion In elderly patients with

关 键 词：糖尿病 2型 糖尿病血管病变 颈动脉内膜中膜厚度 

分 类 号：R587.1[医药卫生—内分泌]