CAJ | 학술논문

目的探讨在2型糖尿病患者中，血清可溶性ST2（sST2）对左心室舒张功能紊乱（LVDD）的诊断价值；比较血清sST2与脑钠肽（ BNP）对LVDD诊断价值的优劣。方法选取2010年11月至2012年12月于内分泌科住院的2型糖尿病患者119例，收集其临床资料并检测生化指标（甘油三酯、总胆固醇、空腹及餐后2 h血清胰岛素、C肽、糖化血红蛋白、BNP等）。所有入组病例接受全面的超声心动图检查以评估左心室舒张功能，并将病例分为以下三组：正常组23例、松弛受损组31例、伪正常组65例。应用酶联免疫吸附法（ELISA）检测血清sST2水平。结果（1）松弛受损组、伪正常组血清sST2、BNP水平均比正常组显著增高（P＜0.05）。（2）血清sST2诊断LVDD的ROC曲线下面积为0.847[95％置信区间（CI）：0.75～0.95，P＝0.000]。 BNP曲线下面积为0.696（95％CI：0.58～0.82，P＝0.005）。两者联合诊断时曲线下面积为0.860（95％CI：0.78～0.94，P＝0.000）。结论在2型糖尿病患者中，血清sST2对LVDD具有诊断价值，其诊断价值优于BNP；血清sST2独立诊断LVDD的价值不劣于两者联合诊断。
목적탐토재2형당뇨병환자중，혈청가용성ST2（sST2）대좌심실서장공능문란（LVDD）적진단개치；비교혈청sST2여뇌납태（ BNP）대LVDD진단개치적우렬。방법선취2010년11월지2012년12월우내분비과주원적2형당뇨병환자119례，수집기림상자료병검측생화지표（감유삼지、총담고순、공복급찬후2 h혈청이도소、C태、당화혈홍단백、BNP등）。소유입조병례접수전면적초성심동도검사이평고좌심실서장공능，병장병례분위이하삼조：정상조23례、송이수손조31례、위정상조65례。응용매련면역흡부법（ELISA）검측혈청sST2수평。결과（1）송이수손조、위정상조혈청sST2、BNP수평균비정상조현저증고（P＜0.05）。（2）혈청sST2진단LVDD적ROC곡선하면적위0.847[95％치신구간（CI）：0.75～0.95，P＝0.000]。 BNP곡선하면적위0.696（95％CI：0.58～0.82，P＝0.005）。량자연합진단시곡선하면적위0.860（95％CI：0.78～0.94，P＝0.000）。결론재2형당뇨병환자중，혈청sST2대LVDD구유진단개치，기진단개치우우BNP；혈청sST2독립진단LVDD적개치불렬우량자연합진단。
Objective To investigate the diagnostic value of serum soluble ST 2 ( sST2 ) levels in patients with type 2 diabetes for left ventricular diastolic dysfunction ( LVDD) .A secondary aim was to compare the diagnostic role between serum sST 2 and brain natriuretic peptide ( BNP ) for detecting LVDD .Methods One hundred and nineteen patients with type 2 diabetes , who were hospitalized in the endocrinology department during Nov .2010 to Dec.2012,were recruited to receive clinical evaluation and biochemical detections (triglyceridemia,cholesterolemia, fasting and 2-hour postprandial blood serum insulin and C peptide ,glycosylated hemoglobin and BNP ).All of them underwent a complete Doppler-echocardiographic evaluation of left ventricular diastolic function .According the result,all subjects were divided into 3 groups as follows:normal ( n =23 ), impaired relaxation ( n =31 ) and pseudonormal filling pattern ( n=65 ) .The levels of serum sST 2 were determined by ELISA technique .Results The levels of serum sST2 were significantly higher in patients with impaired relaxation ,and pseudonormal filling pattern than in patients with normal ( P <0.05 ) .Receiver-operator characteristic curves ( ROC ) for diagnosis of LVDD demonstrated an AUC of 0.847 for sST2[95%confidence interval(CI):0.75 to 0.95;P=0.000],an AUC of 0.696 for BNP(95%CI:0.58 to 0.82;P=0.005),an AUC of 0.860 for combination of both biomarkers (95%CI:0.78 to 0.94;P=0.000).Conclusions Serum soluble ST2 can be used for diagnosis of LVDD in diabetic patients ,and it is better than BNP .The independent diagnostic value of serum sST 2 for LVDD is not be inferior to the joint diagnosis .