高频超声与血清VEGF和bFGF水平检测联合对糖尿病患者肌肉减少症的诊断价值分析  

Diagnostic Value of High Frequency Ultrasound Combined with Serum VEGF and bFGF Levels in Diabetic Patients with Sarcopenia

作　　者：徐珍望 刘佳[1] XU Zhen-wang;LIU Jia(Department of Ultrasound Imaging,Huangshi Central Hospital,Edong Healthcare,Hubei Huangshi 435000,China)

机构地区：[1]鄂东医疗集团黄石市中心医院超声影像科,湖北黄石435000

出　　处：《现代检验医学杂志》2022年第4期75-80,共6页Journal of Modern Laboratory Medicine

基　　金：湖北省卫健委联合基金(WJ2019H157)。

摘　　要：目的探讨高频超声联合血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)诊断糖尿病肌肉减少症的价值。方法选择2018年6月~2019年12月鄂东医疗集团黄石市妇幼保健院收治的103例T2DM并发肌肉减少症患者(观察组)和100例门诊体检健康志愿者(对照组)。根据肌肉减少症分期将观察组分为肌肉减少症前期(简称前期,38例)、肌肉减少症期(简称减少期,34例)和重度肌肉减少症期(简称重度期,31例)。高频超声测量尺骨前肌、股外侧肌厚度和质量,应用酶联免疫吸附试验检测血清VEGF和bFGF水平。Pearson相关性分析尺骨前肌、股外侧肌质量、VEGF和bFGF与四肢骨骼肌质量指数(relative appendicular skeletal muscle mass,RASM)、握力和步速相关性。受试者工作特征曲线(receiver operating characteristic curve,ROC)分析尺骨前肌、股外侧肌质量、VEGF和bFGF诊断T2DM患者肌肉减少症的价值。结果观察组尺骨前肌质量(14.32±3.59)、股外侧肌质量(21.01±3.89)、血清VEGF(185.24±20.13 ng/L)和bFGF(11.35±4.52 ng/L)水平均低于对照组(17.45±4.13,25.12±4.25,236.42±36.49 ng/L,17.64±6.95 ng/L),差异有统计学意义(t=5.768~12.557,均P<0.001)。重度期、减少期患者尺骨前肌质量(11.25±0.42,14.35±2.51)、股外侧肌质量(18.46±0.61,21.34±3.26)、血清VEGF(171.25±3.65 ng/L,178.25±10.43 ng/L)和bFGF(7.42±0.54 ng/L,12.05±2.17 ng/L)水平均低于前期组(16.80±1.03,22.80±1.25,202.91±2.65ng/L,13.93±1.77 ng/L),差异有统计学意义(t=2.560~41.695,均P<0.001)。重度期尺骨前肌质量、股外侧肌质量、血清VEGF和bFGF水平低于减少期,差异有统计学意义(t=3.542~11.551,均P<0.001)。血清VEGF和bFGF水平与尺骨前肌质量、股外侧肌质量、RASM,握力和步速呈正相关(r=0.402~0.698,均P<0.05),尺骨前肌质量、股外侧肌质量与RASM,握力和步速呈正相关(r=0.369~0.719,均P<0.001)�Objective To investigate the value of high-frequency ultrasound combined with serum vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)in the diagnosis of diabetic patients with sarcopenia.Methods 103 patients with T2DM combined with Sarcopenia(observation group)admitted to Huangshi Central Hospital of Edong Healthcare from June 2018 to December 2019 and 100 healthy volunteers(control group)were selected.According to Sarcopenia disease stage,the patients of observation group were divided into prophase period of Sarcopenia(hereinafter referred to as the prophase,38 cases),prophase period(hereinafter referred to as Sarcopenia,34 cases)and severe Sarcopenia period(hereinafter referred to as severe,31 cases).The thickness and mass of anterior ulnar and lateral muscles were measured by high-frequency ultrasound,and the levels of VEGF and bFGF in serum were determined by ELISA.Pearson correlation analysis was performed to determine the correlation between anterior ulnar muscle mass,lateralis muscle mass,VEGF and bFGF and relative appendicular skeletal muscle mass(RASM),grip strength and stride speed.The receiver operating characteristic Curve(ROC)was used to analyze the value of anterior ulnar muscle mass,lateral femoral muscle mass,VEGF and bFGF in the diagnosis of Sarcopenia in patients with T2DM.Results The levels of anterior ulnar muscle mass(14.32±3.59),lateral femoral muscle mass(21.01±3.89),serum VEGF(185.24±20.13 ng/L)and bFGF(11.35±4.52 ng/L)in the observation group were lower than those in the control group(17.45±4.13,25.12±4.25,236.42±36.49 ng/L,17.64±6.95 ng/L),the differences were statistically significant(t=5.768~12.557,all P<0.001).The levels of anterior ulnar muscle mass(11.25±0.42,14.35±2.51),lateral femoral muscle mass(18.46±0.61,21.34±3.26),serum VEGF(171.25±3.65 ng/L,178.25±10.43 ng/L)and bFGF(7.42±0.54 ng/L,12.05±2.17 ng/L)in severe and Sarcopenia group were lower than those in the prophase group(16.80±1.03,22.80±1.25,202.91±2.65ng/L,13.93±1.77 ng/L)

关 键 词：高频超声 血管内皮生长因子 碱性成纤维细胞生长因子 糖尿病肌肉减少症 

分 类 号：R587.2[医药卫生—内分泌] R392.11[医药卫生—内科学]