2型糖尿病患者颈动脉高频超声特点与N~ε-羧甲基赖氨酸水平及其临床应用价值

Carotid high-frequency ultrasonography features and N~ε-(carboxymethyl) lysine level and their clinical utility in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者颈动脉高频超声特点与血清N~ε-羧甲基赖氨酸(CML)水平及其临床应用价值。方法将200例T2DM患者按病程分为≤5年组(观察1组) 120例和>5年组(观察2组)80例,同时选取100例健康体检者为对照组。检测各组CML水平,并行高频超声检查,观察颈动脉斑块形成情况及颈动脉内膜中层厚度(IMT),计算斑块积分。应用受试者工作特征(ROC)曲线评价高频超声、血清CML以及二者联合诊断T2DM患者颈动脉粥样硬化(CAS)血管重构的价值。结果对照组、观察1组、观察2组斑块积分、IMT、血清CML水平、斑块检出率均依次升高(均P<0.05)。高频超声、血清CML以及二者联合应用诊断T2DM患者CAS血管重构的ROC曲线下面积分别为0.872、0.865、0.924(均P<0.05)。结论 T2DM患者更易出现IMT增厚、颈动脉斑块增多、CML升高,且随着糖尿病病程的延长,以上现象加剧。高频超声联合血清CML水平诊断T2DM患者CAS血管重构的价值高于单纯超声和血清CML。

Objective To explore the characteristics of carotid high-frequency ultrasonography,serum N ε-(carboxymethyl) lysine(CML) level,and their clinical utility in patients with type 2 diabetes mellitus(T2DM). Methods A total of 200 patients with T2DM were divided into ≤5 years group(observation group 1, n =120) and >5 years group(observation group 2, n =80)according to the course of disease,meanwhile,100 healthy check-up individuals were enrolled as control group.CML level was detected in each group,and high-frequency ultrasonography was performed to observe carotid plaque forming state and carotid intima-media thickness(IMT),then plaque score was calculated. Receiver operating characteristic(ROC) curve was used to assess the diagnostic value of high-frequency ultrasonography, serum CML,or their combination for carotid atherosclerosis(CAS) vessel remodeling. Results Plaque scores,IMTs,serum CML levels,and plaque detection rates of the control group,the observation group 1,and the observation group 2 increased in turn(all P <0.05).The areas under ROC curve of high-frequency ultrasonography,serum CML and their combination for diagnosing CAS vessel remodeling were 0.872,0.865 and 0.924,respectively(all P <0.05). Conclusion Patients with T2DM are more likely to suffer IMT thickening,increased carotid plaque and elevated CML,and the conditions above are aggravated with prolonged course of diabetes.High-frequency ultrasonography combined with serum CML level is more valuable in diagnosing CAS vessel remodeling than ultrasonography or serum CML alone in patients with T2DM.