2型糖尿病患者踝臂指数与冠状动脉病变程度的相关性研究

摘要

目的：研究2型糖尿病患者踝臂指数与冠状动脉病变程度的关系。方法2012年10月~2014年3月，选择本院确诊的2型糖尿病患者208例，依ABI水平分为A组(ABI<0.9，106例)与B组(ABI≥0.9，102例)，所有患者均行冠状动脉造影术，并进行6个月以上的主要不良心血管事件(MACE)随访。比较两组的冠状动脉病变严重程度及MACE发生率。结果 A组的严重(3支)病变患者比例明显高于B组(P=0.001)，MACE事件发生率显著高于B组(P<0.01)。校正血糖、血脂及一般临床资料等因素后，ABI分别与冠状动脉脉病变数量、Gensini积分呈显著负相关(r=-0.627，P<0.01；r=-0.605，P<0.01)。 ABI在2型糖尿病受试人群中预测冠心病及冠状动脉严重(3支)病变的灵敏度分别为87.1%、66.7%，特异度分别为87.7%、92.5%，准确度分别为87.5%、90.5%。结论 ABI与2型糖尿病患者冠状动脉病变及其严重程度相关，并有一定的预测价值。%Objective To investigate the relationship between ankle brachial index and the degree of coronary artery le-sion in patients with type 2 diabetes. Methods From October 2012 to March 2014,208 patients with type 2 diabetes mellitus (DM) diagnosed by our hospital were selected and divided into group A (ABI<0.9,n=106) and group B (ABI≥0.9,n=102) according to ABI level,all patients were taken coronanry angiography and followed-up for more than 6months about MACE.The severity of coronary artery lesion,incidence rate of MACE between two groups was compared respectively. Results The proportion of patients with severe (three lesions) lesion and incidence rate of MACE in group A was obviously higher than that of group B respectively (P=0.001;P<0.01).After adjustment for blood sugar,blood lipid and other general clinical data and so on,it showed that ABI had a negative correlation with the number of coronary artery lesion (r=-0.627,P<0.01) and Gensini scoring (r=-0.605,P<0.01).The sensitivity and specificity for predicting CAD and severe lesion (three lesions) given ABI in diabetic subjects was 87.1%、66.7% and 87.7%、92.5%respectively, and the accuracy degree was 87.5%,90.5% respectively. Conclusion ABI is associated with the coronary artery disease and its severity in patients with type 2 diabetes mellitus,and it has a certain predictive value.