2型糖尿病患者下肢动脉粥样硬化早期筛查模型的构建  

Construction of early screening model of lower extremity atherosclerosis in patients with type 2 diabetes mellitus

作　　者：侯小文 吴守天 李梦圆 马学娅 鹿亮 谢晖 马祖长[2,3] HOU Xiaowen;WU Shoutian;LI Mengyuan;MA Xueya;LU Liang;XIE Hui;MA Zuchang(School of Nursing,Bengbu Medical University,Bengbu,Anhui 233030,China;不详)

机构地区：[1]蚌埠医科大学护理学院,安徽蚌埠233030 [2]中国科学院合肥物质科学研究院,安徽合肥230031 [3]中国科学技术大学,安徽合肥230026 [4]中国科学技术大学第一附属医院,安徽合肥230022

出　　处：《中国临床研究》2025年第4期563-567,共5页Chinese Journal of Clinical Research

基　　金：合肥市自然科学基金项目(202302)。

摘　　要：目的 分析2型糖尿病(T2DM)患者股动脉内膜中层厚度(IMT)增厚的影响因素,并建立T2DM患者下肢动脉粥样硬化(LEAD)的筛查模型。方法 回顾性选取2022年7月至2024年2月中国科学技术大学第一附属医院住院治疗的369例T2DM患者为研究对象,根据是否有股动脉IMT增厚分为IMT增厚组(n=227)和IMT正常组(n=142)。采用logistic回归分析T2DM患者股动脉IMT增厚的影响因素并构建列线图筛查模型。绘制受试者工作特征(ROC)曲线、校准曲线评价模型的筛查效能、校准度和区分度。结果 227例(61.5%)T2DM患者发生股动脉IMT增厚。年龄大(OR=1.126, 95%CI:1.089~1.164)、体重高(OR=1.031, 95%CI:1.005~1.059)、糖尿病病程长(OR=1.049, 95%CI:1.008~1.091)、高密度脂蛋白胆固醇水平低(OR=0.321, 95%CI:0.115~0.896)、胱抑素C水平高(OR=3.032, 95%CI:1.034~8.889)为发生股动脉IMT增厚的独立危险因素(P<0.05)。基于上述指标构建的筛查模型曲线下面积为0.873,灵敏度0.859,特异度0.711,校正曲线在理想曲线附近。结论 该筛查模型区分度和校准度良好,可直观、简便地甄别T2DM患者LEAD,为早期筛查与干预提供参考。Objective To analyze the influencing factors of femoral artery intima-media thickness(IMT)in patients with type 2 diabetes mellitus(T2DM)and to establish a screening model for lower extremity atherosclerosis disease(LEAD)in patients with T2DM.Methods A total of 369 T2DM patients hospitalized in the First Affiliated Hospital of University of Science and Technology of China from July 2022 to February 2024 were retrospectively selected as the research subjects,and they were divided into the IMT thickening group(n=227)and the IMT normal group(n=142)according to whether there was femoral artery IMT thickening.Logistic regression was used to analyze the influencing factors of femoral artery IMT thickening in T2DM patients and to construct a screening model.The receiver operating characteristic(ROC)curve and calibration curve were plotted to evaluate the screening efficacy,calibration degree and discrimination of the model.Results IMT thickening of the femoral artery occurred in 227(61.5%)patients with T2DM.Elderly age(0R=1.126,95%CI:1.089-1.164),high body weight(OR=1.031,95%CI:1.005-1.059),long duration of diabetes mellitus(OR=1.049,95%CI:1.008-1.091),low HDL-C level(OR=0.321,95%CI:0.115-0.896),high cystatin C level(0R=3.032,95%Cl:1.034-8.889)were the independent risk factors for the D0I:10.13429/j.cnki.cjcr.2025.04.015 occurrence of femoral artery IMT thickening(P<0.05).The area under the curve of the screening model based on the above indicators was 0.873,with the sensitivity of 0.859,the specificity of 0.711,and the calibration curve was near the ideal curve.Conclusion The screening model has good discrimination and calibration,which can intuitively and easily screen LEAD in T2DM patients and provide a reference for early screening and intervention.

关 键 词：糖尿病 下肢动脉粥样硬化 股动脉 内膜中层厚度 列线图 筛查模型 

分 类 号：R587.2[医药卫生—内分泌]