NE在预测糖尿病所致大血管病变中的作用

The role of neutrophil elastase in predicting macrovascular disease caused by diabetes

目的探讨中性粒细胞弹性蛋白酶(NE)在预测糖尿病大血管病变中的作用及预测价值。方法选取2016年6月-2017年12月于彭州市人民医院内分泌科收治住院的181例糖尿病未合并大血管病变患者为A组,88例糖尿病合并大血管病变患者为B组,同期选取32名健康体检者作为对照组。采集并比较各组血清NE水平差异,并按是否发生大血管病变为因变量构建Logistic回归模型以筛选糖尿病患者发生大血管病变的危险因素。使用ROC曲线判定不同截断值时曲线下面积的变化。结果 B组NE水平明显高于A组和对照组[(136.76±20.55)μg/L vs.(23.29±2.27)μg/L vs.(21.78±6.79)μg/L],差异有统计学意义(P<0.05),而A组与对照组间比较差异无统计学意义(P>0.05)。Logistic分析结果显示,血NE水平(OR=1.96,95%CI:1.21～3.18)与病程(OR=4.08,95%CI:1.57～10.57)均为糖尿病患者并发大血管病变的危险因素。ROC曲线结果显示,NE截断点取8μg/L时曲线下面积取最大值0.94,此时灵敏度为96.6%,特异度为90.1%。结论血NE作为糖尿病患者大血管病变诊断标准的灵敏度、特异度均较高,具有一定的临床价值。

Objective To investigate the role and diagnostic value of neutrophil elastase(NE)in predicting diabetic macroangiopathy.Methods 181 patients with diabetes mellitus without macrovascular disease(group A)and 88 patients with diabetes mellitus and macrovascular disease(group B)admitted to the People.s Hospital of Pengzhou during June 2016 to December 2017 were selected for the study,and 32 healthy persons were selected as control group.All the participants accepted the B-type ultrasound examination,and participants with or without macroangiopathy were divided into two groups.Then the level of serum neutrophil elastase was examined and compared among 3 groups.The multivariate analysis was performed by logistic regression analysis.ROC curve was used to determine the change in area under the curve for different cutoff values.Results The level of serum NE in diabetic patients with macroangiopathy was significantly higher than that in patients with non-diabetic macroangiopathy and in control group[(136.76±20.55)μg/L vs.(23.29±2.27)μg/L vs.(21.78±6.79)μg/L](P<0.05),but the difference of NE between diabetes mellitus patients without macroangiopathy and control group shows no statistical significance(P>0.05).The results of logistic model showed that high level of serum NE(OR=1.96,95%CI:1.21~3.18)and period of disease(OR=4.08,95%CI:1.57~10.57)were risk factors for DB macrovascular.The ROC showed that when the cut-off value of serum NE was set at 8μg/L the AUC reach the peak of 0.94;sensitivity and specificity were 96.6%and 90.1%,respectively.Conclusion The sensitivity and specificity of neutrophil elastase in the diagnosis of macrovascular lesions in diabetic patients were high and had some clinical value.