趾臂指数与踝肱指数对诊断2型糖尿病下肢动脉粥样硬化病变的临床价值

摘要

Objective To investigate the feasibility and efficacy of toe index(TBI)and ankle brachial index (ABI)in the clinical diagnosis of atherosclerotic lesions of lower extremity of type 2 diabetes mellitus.Methods A to-tal of 638 patients with type 2 diabetes mellitus who were diagnosed as type 2 diabetes mellitus were enrolled in this study.According to the time of the patients,the patients were divided into two groups(10 years or less),2 patients(≥10 years)of lower extremity atherosclerosis(LEAD)for diabetic patients with ankle-brachial index ≤0.9 for abnormal detection of right-to-arm index(≥0.7)and abnormal index(<0.7).Results The positive predictive value of TBI was 8.9,463 cases were normal,the positive predictive value was 91.7%,the specificity was 86.6%,the negative pre-dictive value was 82.5%and the sensitivity was 89.7%.There was no significant gender difference in the general data (P<0.05).The incidence of hypertension,coronary heart disease and cerebrovascular disease in TBI abnormal group was significantly higher than that in normal group,and the levels of TG and TC in abnormal group were higher than those in normal group and LDL-C.Conclusion TBI can be used to diagnose early atherosclerotic lesions of type 2 diabetes mellitus.%目的 探讨趾臂指数(TBI)、踝肱指数(ABI)用于临床判断2型糖尿病下肢动脉粥样硬化病变的可行性、有效性.方法 以638例2型糖尿病患者为研究对象,根据患者患病时间分为研究1组(10年以下者)、研究2组(≥10年者),对患者进行趾臂、踝肱指数检测,以踝肱指数≤0.9为糖尿病患者下肢动脉粥样硬化(LEAD)诊断标准,观察趾臂指标正常(≥0.7)与指标异常(<0.7)患者疾病检出情况,分析TBI指标用于疾病诊断的临床价值.结果 TBI检测813肢表现为异常,463例为正常,其阳性预测值为91.7%、特异度为86.6%、阴性预测值为82.5%、敏感度为89.7%;TBI异常组高血压、冠心病以及脑血管疾病发生率明显高于正常组,同时异常组TG、TC高于正常组,LDL-C低于正常组(均P<0.05).结论 TBI用于2型糖尿病下肢动脉粥样硬化病变诊断,准确度良好,其能有效诊断早期疾病.