彩色多普勒超声联合血清高敏C反应蛋白和网膜素1检测对老年2型糖尿病合并下肢血管病变的诊断价值  

Diagnostic value of color Doppler ultrasonography combined with serum high-sensitivity C-reactive protein and Omentin-1 in elderly patients with type 2 diabetes mellitus complicated with lower extremity vascular disease

作　　者：陈万峰 王德琴 吉飞跃 Chen Wanfeng;Wang Deqin;Ji Feiyue(Department of Ultrasound,Hai′an People′s Hospital,Hai′an 226600,Jiangsu Province,China;Department of Endocrinology,Hai′an People′s Hospital,Hai′an 226600,Jiangsu Province,China;Clinical Laboratory,Hai′an People′s Hospital,Hai′an 226600,Jiangsu Province,China)

机构地区：[1]海安市人民医院超声科,江苏海安226600 [2]海安市人民医院内分泌科,江苏海安226600 [3]海安市人民医院检验科,江苏海安226600

出　　处：《中华老年多器官疾病杂志》2023年第12期905-909,共5页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：江苏省卫生健康委科研课题(H2018053)。

摘　　要：目的探讨彩色多普勒超声(CDU)联合血清高敏C反应蛋白(hs-CRP)和网膜素1(Omentin-1)检测对老年2型糖尿病(T2DM)合并下肢血管病变(LEVD)的诊断价值。方法选择2020年7月至2022年10月海安市人民医院收治的老年T2DM患者250例,根据是否合并LEVD分为T2DM组(118例)和T2DM-LEVD组(132例);选择同期体检的100名老年健康志愿者,列入正常组(NC组)。采集研究对象的一般资料,行CDU检查获得双下肢血流动力学、斑块形成率、足背动脉狭窄率,测定血清hs-CRP和Omentin-1水平,比较3组上述指标差异。采用二元logisti c回归模型分析影响T2DM-LEVD的因素,绘制受试者工作特征(ROC)曲线,分析CDU联合血清hs-CRP、Omentin-1检测对T2DM-LEVD的诊断价值。采用SPSS 24.0软件进行数据分析。根据数据类型,组间比较分别采用t检验、χ^(2)检验及方差分析。结果3组的性别、年龄、体质量指数(BMI)、吸烟史、饮酒史、病程比较,差异无统计学意义(P>0.05);T2DM-LEVD组的糖化血红蛋白(HbA1c)、空腹血糖(FPG)、总胆固醇(TC)、甘油三酯(TG)、空腹胰岛素(FINS)、胰岛素抵抗(HOMA-IR)指数、尿素氮(BUN)水平,斑块形成率和足背动脉狭窄率、以及血清hs-CRP水平均高于T2DM组和NC组,T2DM组高于NC组;T2DM-LEVD组的高密度脂蛋白胆固醇(HDL-C)和白蛋白(ALB),股动脉、腘动脉和足背动脉的内径和血流量,以及血清Omentin-1水平均低于T2DM组和NC组,T2DM组低于NC组,差异均有统计学意义(P<0.05)。logistic分析显示,HbA1c、FPG、股动脉、腘动脉、足背动脉的内径和血流量、hs-CRP、Omentin-1为影响T2DM-LEVD发生的因素(P<0.05)。ROC曲线显示,CDU、hs-CRP、Omentin-1联合诊断T2DM-LEVD的ROC曲线下面积(AUC)、灵敏度和特异度高于任一单项效能(P<0.05)。结论CDU联合血清hs-CRP和Omentin-1水平检测对老年T2DM合并LEVD患者的临床诊断价值较高。Objective To investigate the diagnostic value of color Doppler ultrasonography(CDU)combined with serum high-sensitivity C-reactive protein(hs-CRP)and Omentin-1(OMentin-1)in the elderly patients with type 2 diabetes mellitus(T2DM)complicated with lower extremity vascular disease(LEVD).Methods A total of 250 elderly T2DM patients admitted to the Hai′an People′s Hospital from July 2020 to October 2022 were selected and divided into T2DM group(n=118)and T2DM-LEVD group(n=132)according to the occurrence of LEVD.Another 100 healthy elderly volunteers who underwent physical examination during the same period were selected as the normal group(NC group).General data of the subjects were collected,and CDU was performed to obtain the lower extremity hemodynamics,plaque formation rate and rate of dorsalis pedis artery stenosis.Serum hs-CRP and Omentin-1 levels were measured.The three groups were compared in the above indexes.Binary logistic regression model was used to analyze factors affecting T2DM-LEVD,and receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of the CDU combined with serum hs-CRP and Omentin-1 detection for T2DM-LEVD.SPSS statistics 24.0 was used for statistical analysis.Data comparison between two groups was perfomed using t test,χ^(2)test or analysis of variance depending on data type.Results There were no diffe-rences in gender,age,body mass index(BMI),history of smoking,history of drinking,and course of disease among the three groups(P>0.05).The levels of glycosylated hemoglobin(HbA1c),fasting blood glucose(FPG),total cholesterol(TC),triglyceride(TG),fasting insulin(FINS),insulin resistance(HOMA-IR)index,urea nitrogen(BUN),rate of plaque formation,rate of dorsalis pedis artery stenosis,and the serum hs-CRP in the T2DM-LEVD group were higher than those in the T2DM and NC groups,and those in the T2DM group were higher than those in the NC group.The high-density lipoprotein cholesterol(HDL-C)and albumin(ALB),internal diameter and blood flow of the femoral artery,poplit

关 键 词：彩色多普勒超声 超敏C反应蛋白 网膜素1 2型糖尿病 下肢血管病变 诊断价值 

分 类 号：R587.2[医药卫生—内分泌] R445.1[医药卫生—内科学]