循环内皮素-1对于冠心病合并2型糖尿病的临床意义

The value of circulating endothelin-1 in coronary artery disease patients with type 2 diabetes mellitus

目的:探讨冠心病合并2型糖尿病的患者循环内皮素-1(ET-1)水平变化的临床意义。方法:随机纳入2014年8月~2016年1月就诊于我院心内科以冠心病为主要诊断且合并2型糖尿病的患者共90名,受试者入院均接受冠状动脉造影术,以ET-1的中位数为界,分为高ET-1组和低ET-1组。随访患者1年内发生主要不良心血管事件(MACE)情况。观察冠状动脉病变支数、糖化血红蛋白A1c(HbA1c)及MACE与ET-1的关系;应用受试者工作特征曲线(ROC)分析ET-1估测患者临床预后的价值。结果:高ET-1组患者LDL、HbA1c水平明显高于ET-1组;多支血管病变患者ET-1水平高于单支病变者;HbA1c与ET-1之间呈正相关关系;发生MACE的患者ET-1水平更高;ROC曲线发现,ET-1用于评估合并2型糖尿病患者的临床预后具有较高价值。结论:循环内皮素-1可以作为评估合并2型糖尿病的冠心病患者的病情及临床预后的指标。

Objective To investigate the value of circulating endothelin-1 in coronary artery disease(CAD)patients with type 2 diabetes mellitus.Methods A total of 90 CAD patients with T2DM were collected which was admitted to cardiology departments and underwent coronary angiography in our hospital from August 2014 to January 2016.All of them were divided into the higher ET-1 group and the lower ET-1 group.The major adverse cardiovascular events(MACE)was occurred within 1 year.To analyze the relationship between the level of ET-1 at admission with hemoglobin A1c(HbA1c)and number of coronary artery lesions and major adverse cardiovascular events(MACE).Receiver operating characteristic(ROC)curve analysis was applied to estimate the value of ET-1 for MACE in CAD patients with T2DM.Results We found that the level of LDL and HbA1c of higher ET-1were significantly higher the lower ET-1group;The level of ET-1 were higher in Multi-vessel lesions than single-vessel lesions;what’s more,the level of ET-1 was positively correlated with the levels of HbA1c.At follow-up,the level of ET-1 in MACE patients significantly higher than those without,at the same time,the area under the receiver operating characteristic curve(AUC)was 0.83(0.75~0.91).Conclusion Circulating ET-1 may serve as an index to assess the condition and prognosis of CAD patients with T2DM.