超声测量踝肱指数、纤维蛋白原、D-二聚体联合检测在中年2型糖尿病患者下肢血管病变中的应用价值

Application value of ultrasound measurement of ankle-brachial index combined detection of fibrinogen and D-dimer in lower extremity vascular disease in middle-aged patients with type 2 diabetes mellitus

目的探讨超声测量踝肱指数(ABI)、纤维蛋白原(FIB)、D-二聚体(D-D)联合检测在中年2型糖尿病(T2DM)患者下肢血管病变(LEAD)中的应用价值。方法收集2021年2月至2023年2月于新疆医科大学第二附属医院就诊的210例T2DM患者的临床资料,根据患者是否发生LEAD将其分为病变组(n=55)和非病变组(n=155)。收集患者的相关指标,分析T2DM患者发生LEAD的影响因素,并采用受试者工作特征(ROC)曲线下面积(AUC)分析ABI、FIB、D-D单独及联合检测T2DM患者发生LEAD的诊断效能。结果病变组患者糖尿病(DM)病程长于非病变组患者,年龄、腰臀比(WHR)、糖化血红蛋白(HbA1c)、超敏C反应蛋白(hs-CRP)、甘油三酯(TG)、FIB、D-D均高于非病变组患者,ABI低于非病变组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,长DM病程和高水平HbA1c、FIB、D-D及低ABI均是T2DM患者发生LEAD的危险因素(P﹤0.05)。ABI、FIB、D-D联合检测诊断T2DM患者发生LEAD的AUC(95%CI)为0.947(0.907~0.973),均高于各项单独检测(P﹤0.05)。结论ABI、FIB及D-D与T2DM患者发生LEAD密切相关,且ABI、FIB、D-D联合检测对筛查中年T2DM患者发生LEAD具有较高的参考价值。

Objective To investigate the application value of ultrasound measurement of ankle-brachial index(ABI),combined detection of fibrinogen(FIB)and D-dimer(D-D)in lower extremity vascular disease in middle-aged patients with type 2 diabetes mellitus(T2DM).Method Clinical data of 210 T2DM patients admitted to the Second Affiliated Hospital of Xinjiang Medical University from February 2021 to February 2023 were collected and divided into pathological group(n=55)and non-pathological group(n=155)according to whether they developed LEAD.The relevant indicators of patients were collected,the influencing factors of LEAD in T2DM patients were analyzed,the receiver operating characteristic(ROC)area under curve(AUC)was used to analyze the diagnostic efficacy of ABI,FIB,D-D alone and combined detection of LEAD in T2DM patients.Result The duration of diabetes mellitus(DM)in the pathological group was longer than that in the non-pathological group,the age,waist-to-hip ratio(WHR),HbA1c,hypersensitive C-reactive protein(hs-CRP),triglyceride(TG),FIB and D-D were all higher than those in the non-pathological group,while the ABI value was lower than that in the non-pathological group,the differences were statistically significant(P<0.05).Multi-factor analysis showed that long DM course,high level of HbA1c,FIB,D-D and low ABI were all the risk factors of LEAD in T2DM patients(P<0.05).The AUC(95%CI)of ABI,FIB and D-D combined detection for LEAD in T2DM patients was 0.947(0.907-0.973),which was higher than that of each single detection(P<0.05).Conclusion ABI,FIB and D-D are closely related to the occurrence of LEAD in T2DM patients,the combined detection of ABI,FIB and D-D has a high reference value for screening the occurrence of LEAD in middle-aged T2DM patients.