【摘要】 目的 探讨2型糖尿病患者颈动脉内-中膜厚度(IMT)和低密度脂蛋白(LDL)/高密度脂蛋白(HDL)胆固醇比值对冠状动脉(冠脉)狭窄的预测价值。方法 112例2型糖尿病患者根据冠脉造影结果分成冠心病组(冠脉狭窄≥50%,67例)和对照组(冠脉狭窄0~49%,45例),超声检测颈动脉最大IMT(maxIMT),抽血检测LDL、HDL胆固醇水平。结果 冠心病组max-IMT、LDL/HDL均明显大于对照组[(2.65±0.75)mm比(1.59±0.47)mm,3.1±0.9比2.5±0.7,均P<0.05]。Spearman秩相关分析显示,max-IMT和冠脉狭窄率呈正相关关系(r=0.46,P<0.05)。ROC曲线分析显示,max-IMT、LDL/HDL和二者联合指标预测冠脉狭窄的曲线下面积(AUC)分别为0.702、0.617和0.888。结论 2型糖尿病患者颈动脉max-IMT、LDL/HDL与冠脉狭窄密切相关,联合max-IMT和LDL/HDL可更好预测冠脉狭窄。更多还原

【Abstract】 Objective To explore the value of carotid intima-media thickness and LDL-to-HDL cholesterol ratio in predicting coronary stenosis in patients with type 2 diabetes mellitus.Methods One hundred and twelve patients with type 2 diabetes mellitus underwent coronary angiography were divided into two groups according to the percent of coronary stenosis,the coronary heart disease group(stenosis ≥ 50%,n=67) and the control group(stenosis 0-49%,n=45).The maximum carotid intima-media thickness(max-IMT) was detected by external carotid ultrasound.Low-density lipoprotein(LDL) cholesterol and high-density lipoprotein(HDL) cholesterol was determined from blood samples.Results Max-IMT and LDL/HDL ratio in the coronary heart disease group were significantly greater than in the control group[(2.65±0.75)mm vs(1.59±0.47)mm,3.1±0.9 vs 2.5±0.7,all P<0.05].Spearman’s rank correlation analysis showed that a significant correlation was found between max-IMT and coronary artery stenosis(r=0.46,P<0.05).Areas under the curves(AUC) in receiver operating characteristic(ROC) curve analysis of max-IMT,LDL/HDL,and these two parameters combined were 0.702,0.617 and 0.888 respectively,for predicting coronary artery stenosis.Conclusion In type 2 diabetic patients,max-IMT and LDL/HDL are closely associated with coronary stenosis,and the combination of max-IMT and LDL/HDL improve the prediction of coronary artery stenosis.更多还原