胰腺脂肪浸润的CT参数与2型糖尿病合并脑梗死的相关性研究  

Correlation Between CT Findings of Pancreatic Steatosis and Type 2 Diabetes Mellitus Patients Complicated with Cerebra Infarction

作　　者：陆雨纯 应长江 沃眉宏 孙莉 LU Yuchun;YING Changjiang;WO Meihong(Xuzhou Medical University,Jiangsu 221004,China)

机构地区：[1]徐州医科大学,221004 [2]徐州医科大学附属医院内分泌科,221004

出　　处：《医学研究杂志》2023年第7期66-70,共5页Journal of Medical Research

基　　金：中国博士后科学基金资助项目(2019M651970)。

摘　　要：目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并脑梗死(cerebra infarction,CI)患者胰腺脂肪浸润(pancreatic steatosis,PS)的CT参数差异,及其与CI的相关性。方法连续性纳入2018年10月~2022年2月在徐州医科大学附属医院住院的T2DM患者152例,根据头颅CT结果按照是否合并CI分为两组,即单纯T2DM组(单纯组,n=44)及T2DM合并CI组(脑梗死组,n=108),同时选取同期体检的健康人群作为对照组(n=41)。收集纳入患者的临床资料,并检测胱抑素C(Cyc-C)、血脂等生化指标。在腹部CT平扫上测量胰腺及脾脏的CT密度(HU值),计算胰腺及脾脏平均值(P_(平均)、S_(平均)),并计算胰腺CT密度指数[胰腺与脾脏的密度差值(P-S)和胰腺与脾脏的密度比值(P/S)]。比较不同组间临床资料的差异,采用Logistic回归模型筛选T2DM合并CI的危险因素,选用受试者工作特征(receiver operator characteristic,ROC)曲线获得P/S的最佳截断值。结果3组患者P_(平均)、P-S、P/S比较,脑梗死组<单纯组<NC组,差异均有统计学意义(P<0.001),脑梗死组患者的胰头、胰体、胰尾CT值比较,差异均有统计学意义(P<0.001)。Logistic回归分析结果表明,P/S、Cys-C为影响T2DM患者发生CI的影响因素,校正混杂因素后,P/S与T2DM合并脑梗死仍具有相关性。ROC曲线分析结果显示,P/S预测CI的曲线下面积为0.731(95%CI:0.634~0.827,P<0.001);P/S预测脑梗死的最佳截断值为0.8467,对应的敏感度为80.6%,对应的特异性为61.4%。结论T2DM患者常存在PS,PS为T2DM患者合并脑梗死的危险因素,PS的严重程度对T2DM合并CI人群具有一定的预测价值。Objective To investigate the degree of pancreatic steatosis(PS)in patients with type 2diabetes mellitus(T2DM)complicated with cerebra infarction(CI),and it,s correlation with CI.Methods One hundred and fifty-two patients with T2DM who were hospitalized in the Affiliated Hospital of Xuzhou Medical University were enrolled from October 2018 to February 2022.According to the CT finding,patients were divided into simple T2DM group(simple group,n=44)and T2DM with CI group(CI group,n=108).Meanwhile choose 41subjects of health examination as normal control group.Collect the clinical data and detect biochemical parameters.The CT attenuation(HU)of pancreas and spleen was measured on abdominal CT scan,and the average attenuation of pancreas and spleen(P mean,S mean)was calculated.The CT attenuation indexes including the difference between pancreatic and splenic attenuation(P-S)and the ratio of pancreas to spleen attenuation(P/S)were calculated.Compare the clinical data of different groups of participants.Logistic regression analysis was used to analyze the risk factors of T2DM with CI.The optimum cut-off value of P/S was depicted by receiver operator characteristic(ROC)curve.Results There were significant differences in average CT attenuation of pancreas,P-S and P/S among three groups(P<0.001).There were significant differences in CT attenuation of pancreatic head,body and tail in CI group(P<0.001).Logistic regression analysis showed that Cys-C and P/S were the factors affecting the incidence of CI in T2DM patients.After adjusting for confounding factors,P/S was still significantly correlated with CI in T2DM patients.ROC curve analysis showed the area under the curve that P/S predicted the CI in T2DM patients was 0.731(95%CI:0.634-0.827,P<0.001).The optimum cut-off value of P/S for predicting the CI was 0.8467,the corresponding sensitivity was 80.6%,and the corresponding specificity was 61.4%.Conclusion Patients with T2DM frequently have PS,and PS is a risk factor for the CI in patients with T2DM.The severity of PS may hav

关 键 词：2型糖尿病 胰腺脂肪浸润 脑梗死 计算机断层扫描 

分 类 号：R5[医药卫生—内科学]