应用ROC曲线分析ET参数在诊断2型糖尿病患者颈总动脉弹性中的作用

The clinical application of E-tracking technique in assessing common carotid artery elasticitiy in T2DM patients

目的应用ROC曲线分析血管回声跟踪技术(echo tracking,ET)对2型糖尿病(T2DM)患者的颈总动脉弹性的评价作用。方法T2DM60例,正常对照60例,应用ET技术检测颈动脉硬化参数,包括压力应变弹性系数(Ep)、硬度指数(β)、顺应性(AC)及脉搏波传导速度(PWVβ)和膨大系数(AI),并对上述参数进行统计学分析,初步确定颈动脉硬化ET参数诊断截断值。结果T2DM组颈动脉β,Ep,PWVβ均较正常对照组升高(P<0.01),AC均较对照组降低(P<0.01),AI差别不明显(P>0.05);ROC分析β,Ep,PWVβ,AC的曲线下面积分别为0.81,0.85,0.86,0.77,建议分别以β8.50,Ep108.5kPa,PWVβ6.65m/s,AC0.76mm2/kPa作为T2DM患者颈动脉硬化的诊断截断值。结论糖尿病动脉弹性下降发生在内中膜(IMT)增厚之前,其中以β,Ep,PWVβ作为T2DM患者颈总动脉硬化参数评价的准确性较高,AC可作为辅助参考指标。

Objective To study the features of the common carotid artery by echo - tracking （ET） technique in type 2 diabetic （T2DM） patients. Methods Sixty T2DM patient were enrolled in the study and 60 normal persons served as control. ET technique was used to evaluate the common carotid artery elasticity modulus, such as stiffness parameter （ β）, pressure strain elastic modulus （ Ep）, arterial compliance （ AC ）, augment index （AI） and pulse wave conducting velocity（ PWVβ）. Results Compared with the normal group, β, Ep and PWVβ of the common carotid artery were significantly higher（ P 〈 0.01 ）and AC significantly lower（P 〈0.01 ） in T2DM group, but the difference in AI was not significant（ P 〉0.05）; Through the receiver operating characteristic curve （ROC） analysis, the area under the curve were 0. 81, 0. 85, 0. 86 and 0.77 for β, Ep, PWVβ and AC respectively. We recommended 8.50, 108.5Kpa, 6.65m/s and 0. 76 mm^2/kPa as diagnostic the cut - off value for β, Ep, PWVβ and AC in T2DM patients. Conclusion Diabetes artery flexibility decreases before the IMT is thickened, which can be assess accurately by using β, Ep and PWVβ. AC can be used as an auxiliary reference.