2型糖尿病患者股动脉内膜中层厚度、踝臂指数对冠状动脉粥样硬化性心脏病的预测价值

发布时间：2018-01-25 14:40

本文关键词： 2型糖尿病冠状动脉粥样硬化性心脏病股动脉内膜中层厚度踝臂指数　出处：《蚌埠医学院》2016年硕士论文　论文类型：学位论文

【摘要】：目的:本研究通过观察单纯2型糖尿病(T2DM)组、T2DM合并冠状动脉粥样硬化性心脏病(CAD)组生化指标、股动脉内中膜厚度(FAIMT)、踝臂指数(ABI)的变化,比较组间各指标的差别,评价FAIMT、ABI对T2DM患者CAD的预测价值。方法:选取2014.10-2015.11我院内分泌科住院的T2DM患者150例为研究对象,分为非冠状动脉粥样硬化性心脏病组(NCAD组)、CAD组,CAD组再根据冠状动脉病变支数分为单支病变组(CAD1组)、多支病变组(CAD2组),对其临床资料、生化指标、FAIMT、ABI、CAD的发生及冠状动脉病变情况进行统计学分析。结果:HDL-C在NCAD组与CAD2组之间有统计学差异(P0.05),其余生化指标组间无统计学差异。NCAD组与CAD组、NCAD组与CAD2组相比较,ABI和FAIMT值均有显著性差异(P0.01);而CAD1组与CAD2组相比,仅有FAIMT值有统计学差异(P0.01),ABI并无显著性差异。多因素回归分析结果表明,ABI(β=-0.626,P0.05)、FAIMT(β=1.309,P0.01)是冠心病发生的独立危险因素。ROC曲线分析发现FAIMT为0.875mm时对CAD的预测价值最高,灵敏度为79%,特异度为92%,曲线下面积(AUC)为0.891,P0.01;FAIMT预测冠状动脉严重病变的曲线下面积为0.818,P0.01,FAIMT值为1.025mm时对冠状动脉严重病变的预测价值最高,灵敏度为60%,特异度为92%;ABI值为0.99时,对CAD的阴性预测价值最高,AUC为0.789,P0.01,灵敏度为76%,特异度为72%,但是对CAD的阳性预测价值不高(AUC=0.2110.5)。结论:T2DM合并CAD组中FAIMT显著高于NCAD组,ABI低于NCAD组,并且FAIMT在CAD2组中高于CAD1组,两组间差异有统计学意义,对冠状动脉粥样硬化病变程度的评估有较好的提示作用。FAIMT、ABI与CAD有显著的相关性,均是CAD的独立危险因素,同时两者对CAD的诊断有一定的预测价值。
[Abstract]:Objective: to observe the biochemical indexes and medial thickness of femoral artery (IMT) of T2DM with coronary atherosclerotic heart disease (CAD) in type 2 diabetes mellitus (T2DM) group. The change of ankle brachial index (ABI), compare the difference of each index between groups, and evaluate the FAIMT. The predictive value of ABI for CAD in patients with T2DM. Methods: 150 cases of T2DM patients hospitalized in Endocrinology Department of our hospital from October to November 2014.were selected as study subjects. The patients were divided into non-coronary atherosclerotic heart disease group (NCAD group) and CAD group (CAD group was divided into single vessel lesion group (CAD1 group) according to the number of coronary artery disease branches). The clinical data and biochemical index of CAD2 group were compared with that of FAIMT ABI. The incidence of CAD and coronary artery disease were statistically analyzed. Results there was significant difference between NCAD group and CAD2 group (P 0.05). There was no statistical difference in the other biochemical indexes between the two groups. There was significant difference in ABI and FAIMT between NCAD group and CAD group compared with CAD2 group (P 0.01). However, there was no significant difference in FAIMT between CAD1 group and CAD2 group. The results of multivariate regression analysis showed that there was no significant difference in FAIMT value between CAD1 group and CAD2 group. ABI (尾 -0.626 P0.05) FAIMT (尾 1. 309). P0.01) was an independent risk factor for coronary heart disease. ROC curve analysis showed that when FAIMT was 0.875 mm, the predictive value of CAD was the highest, and the sensitivity was 79%. The specificity was 92 and the area under the curve was 0.891p0.01; When the area under the curve of FAIMT for predicting severe coronary artery disease was 0.818 渭 m P0.01FIMT was 1.025mm, it had the highest predictive value for severe coronary artery disease. The sensitivity was 60 and the specificity was 92. When ABI value was 0.99, the negative predictive value of CAD was the highest (0.789% P0.01), the sensitivity was 76% and the specificity was 72%. However, the positive predictive value of CAD was not high. Conclusion the FAIMT in CAD group with T2DM is significantly higher than that in NCAD group and NCAD group. And the FAIMT in CAD2 group is higher than that in CAD1 group, the difference between the two groups is statistically significant, which has a better role in the evaluation of coronary atherosclerosis. Both ABI and CAD are independent risk factors for CAD, and both have predictive value in the diagnosis of CAD.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R587.1;R541.4

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