踝肱指数联合血管内皮功能对2型糖尿病合并冠心病患者冠状动脉狭窄程度的预测价值

doi:10.3969/j.issn.1671-7171.2021.07.027

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摘要【目的】探讨踝肱指数(ABI)、血管内皮功能(FMD)对2型糖尿病(T2DM)合并冠心病患者冠状动脉狭窄程度的预测价值。【方法】选取2018年1月到2019年1月在西安高新医院内分泌科诊治的150例T2DM合并冠心病患者作为观察组,另外选取同期在同院诊治30例无冠心病的T2DM患者作为对照组。观察组患者分为冠状动脉单支病变组(n=65例)、双支病变组(n=50)、严重病变组(三支病变组,n=35),检查并比较各组FMD和ABI,分析FMD和ABI对T2DM合并冠心病患者冠状动脉狭窄程度的预测价值。【结果】观察组FMD、ABI显著低于对照组,差异有统计学意义(P<0.05)。单支病变组、双支病变组、严重病变组的FMD、ABI依次降低,组间比较差异均有统计学意义(P<0.05)。FMD与ABI呈正相关(r=0.35,P=0.02);FMD、ABI与冠状动脉 Gensini 评分呈负相关(r=-0.45,P=0.01;r=-0.49,P=0.00)。FMD、ABI诊断冠状动脉狭窄程度的ROC曲线下面积(95%CI)分别为0.71(0.64～0.82)、0.75(0.68～0.87),特异度分别为67.2%、66.1%,灵敏度分别为76.9%、79.1%。FMD和ABI联合诊断冠状动脉狭窄程度的特异度为60.2%,灵敏度为85.3%。【结论】T2DM合并冠心病患者FMD和ABI降低,且FMD、ABI与冠状动脉狭窄程度呈负相关,联合FMD和ABI检测对T2DM合并冠心病患者冠状动脉狭窄程度具有较高的诊断价值。

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	邢蒙
	刘晋津

关键词 ：冠心病/并发症, 糖尿病, 2型/并发症, 冠状动脉疾病, 踝, 肱骨

Abstract：【Objective】To observe the value of ankle brachial index(ABI) and vascular endothelial function(FMD) on type 2 diabetes with coronary stenosis. 【Methods】From January 2018 to January 2019, 150 patients with type 2 diabetes mellitus(T2DM) and coronary heart disease who underwent coronary CTA in Department of Endocrinology, Xi'an High-Tech Hospital were selected as the observation group, and 30 patients with type 2 diabetes mellitus without coronary heart disease were selected as the control group. The 150 patients in the observation group were divided into the single-vessel disease group(65 cases), the double-vessel disease group(50 cases), and the severe disease group(triple-vessel, 35 cases). The FMD and ABI for each group were checked and compared. 【Results】The FMD and ABI in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). The FMD and ABI in the severe lesion group were lower than those in the double-vessel disease group and single-vessel disease group; the difference was statistically significant(P<0.05). The FMD and ABI of the double-vessel disease group were lower than those in the single-vessel disease group; the difference was statistically significant(P<0.05). FMD was positively correlated with ABI(r=0.35, P=0.02), while FMD and ABI were negatively correlated with Gensini scores(r=-0.45, -0.49, P=0.01, 0.00). The area under the ROC curve(AUC)(95%CI) of FMD and ABI for the diagnosis of severe coronary heart disease was 0.71(0.64-0.82) and 0.75(0.68-0.87), respectively, the specificity of them in diagnosis of coronary heart severe disease was 67.2% and 66.1%, respectively, and the sensitivity was 76.9% and 79.1%, respectively. The specificity of FMD combined with ABI in the diagnosis of coronary heart severe disease was 60.2%, and the sensitivity was 85.3%.【Conclusion】 FMD and ABI are reduced in patients with diabetic coronary stenosis. FMD and ABI have negative correlation with the degree of stenosis. The combination of FMD and ABI is of high value in predicting coronary heart severe disease in patients with type 2 diabetes.

Key words： Coronary Disease/CO Diabetes Mellitus, Type 2/CO Coronary Artery Disease Ankle Humerus

收稿日期: 2021-01-14

中图分类号:

R542.22

通讯作者: *E-mail:jinjin8652@126.com

引用本文:

邢蒙, 刘晋津. 踝肱指数联合血管内皮功能对2型糖尿病合并冠心病患者冠状动脉狭窄程度的预测价值[J]. 医学临床研究, 2021, 38(7): 1055-1058.
XING Meng, LIU Jin-jin. Value of Ankle-Brachial Index Combined with Vascular Endothelial Function Indexes in Predicting Coronary Artery Stenosis in Diabetic Patients with Coronary Disease. JOURNAL OF CLINICAL RESEARCH, 2021, 38(7): 1055-1058.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.07.027 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I7/1055

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