CAJ | 학술논문

目的：应用sROC曲线评价实验室多项指标对预测2型糖尿病（T2DM ）初发缺血性脑卒中的实用价值。方法收集30例确诊的T2DM 初级发生脑卒中患者、30例未发生脑卒中的 T2DM 患者，检测 T2DM 初发缺血性脑卒中患者血浆白细胞介素‐6（IL‐6）、白细胞介素‐10（IL‐10）、白细胞介素‐18（IL‐18）、肿瘤坏死因子‐α（T N F‐α）、血小板膜糖蛋白CD62及超敏C‐反应蛋白（hs‐CRP）、D‐二聚体（D‐D）、同型半胱氨酸（HCY），并以未发生脑卒中的T2DM患者和健康人作为对照，比较3组受试者上述指标水平，并用sROC曲线评价这些指标的临床应用价值。结果 T2DM初发缺血性脑卒中组各参数均高于 T2DM 无脑卒中组，差异有统计学意义；T2DM 两组均高于健康对照组，差异有统计学意义。由sROC曲线可知，各参数对 T2DM 患者初发缺血性脑卒中诊断价值从高到低依次为 hs‐CRP、IL‐10、HCY、IL‐6、TNF‐α、D‐D、CD62、IL‐18，曲线下面积分别为1．000、0．993、0．982、0．956、0．947、0．930、0．918、0．871。结论 IL‐6、IL‐10、IL‐18、TNF‐α、CD62、hs‐CRP、D‐D、HCY各参数均可以预测 T2DM 脑卒中，但灵敏度与特异性均较高的是hs‐CRP、IL‐10、HCY。
목적：응용sROC곡선평개실험실다항지표대예측2형당뇨병（T2DM ）초발결혈성뇌졸중적실용개치。방법수집30례학진적T2DM 초급발생뇌졸중환자、30례미발생뇌졸중적 T2DM 환자，검측 T2DM 초발결혈성뇌졸중환자혈장백세포개소‐6（IL‐6）、백세포개소‐10（IL‐10）、백세포개소‐18（IL‐18）、종류배사인자‐α（T N F‐α）、혈소판막당단백CD62급초민C‐반응단백（hs‐CRP）、D‐이취체（D‐D）、동형반광안산（HCY），병이미발생뇌졸중적T2DM환자화건강인작위대조，비교3조수시자상술지표수평，병용sROC곡선평개저사지표적림상응용개치。결과 T2DM초발결혈성뇌졸중조각삼수균고우 T2DM 무뇌졸중조，차이유통계학의의；T2DM 량조균고우건강대조조，차이유통계학의의。유sROC곡선가지，각삼수대 T2DM 환자초발결혈성뇌졸중진단개치종고도저의차위 hs‐CRP、IL‐10、HCY、IL‐6、TNF‐α、D‐D、CD62、IL‐18，곡선하면적분별위1．000、0．993、0．982、0．956、0．947、0．930、0．918、0．871。결론 IL‐6、IL‐10、IL‐18、TNF‐α、CD62、hs‐CRP、D‐D、HCY각삼수균가이예측 T2DM 뇌졸중，단령민도여특이성균교고적시hs‐CRP、IL‐10、HCY。
Objective To use the summary receiver operating characteristic (sROC ) curve to evaluate the practical value of the multiple laboratory indexes for predicting the first attack of ischemic cerebral stroke in type 2 diabetes mellitus(T2DM ) .Methods The blood samples were collected from the T 2DM patients with the first attack of ischemic cerebral stroke ,30 T2DM patients without stroke and 30 healthy persons as the controls .The IL‐6 ,IL‐10 ,IL‐18 ,TNF‐α,CD62 ,hs‐CRP ,D‐D and HCY were detected .The detection levels of above indexes were compared among 3 groups and their clinical application values were evaluated by the sROC curves .Results The levels of vari‐ous parameters in the T2DM patients with first attack of ischemic cerebral stroke were higher than those in the T2DM patients without stroke ,the differences had statistical significance ;the levels in the two groups of T2DM were higher than those in the normal healthy control group with statistical differences ;The sROC curves indicated that the values of the various parameters for diagnosing the first attack of ischemic cerebral stroke in turn were hs‐CRP ,IL‐10 ,HCY ,IL‐6 ,TNF‐α,D‐D ,CD62 and IL‐18 ,and the areas under the curve(AUC) were 1 .000 ,0 .993 ,0 .982 ,0 .956 , 0 .947 ,0 .930 ,0 .918 and 0 .871 .Conclusion The various parameters of IL‐6 ,IL‐10 ,IL‐18 ,TNF‐α,CD62 ,hs‐CRP ,D‐D and HCY can be used to predict the T2DM with ischemic cerebral stroke ,but hs‐CRP ,D‐D and HCY simultane‐ously have higher sensitivity and higher specificity .