CAJ | 학술논문

【目的】评价2型糖尿病患者踝臂指数（ABI）对冠脉病变程度的预测价值。【方法】选择本院2型糖尿病患者208例，依ABI水平分为A组（ABI＜0．9，106例）与B组（ABI≥0．9，102例），比较两组患者冠脉病变严重程度及主要心脏不良事件（MACE）发生率。【结果】A组的冠脉严重（三支）病变患者及MACE发生率明显多于B组（ P ＜0．01）。ABI值与冠状动脉病变数量呈显著负相关（ r ＝－0．627，P ＜0．01）。在调整了临床资料及血糖等影响因素后，ABI＜0．9在糖尿病受试人群中预测冠状严重（三支）的敏感性为66．7％，特异性为92．5％，准确度为90．5％（OR值17．171，95％可信区间分别为：4．069～22．456，P＜0．01）。评价ABI对冠状严重（三支）病变预测价值的ROC曲线下面积为（0．825±0．42），95％可信区间为（0．743～0．907）（ P ＜0．01），其中以ABI＝0．84为最佳预测临界点（敏度为67％，特异度为93％，Youden指数最高为0．601）。【结论】ABI作为下肢动脉粥样硬化无创监测手段，对2型糖尿病患者冠脉病变程度有一定预测价值，可用于识别冠心病高危患者。
【목적】평개2형당뇨병환자과비지수（ABI）대관맥병변정도적예측개치。【방법】선택본원2형당뇨병환자208례，의ABI수평분위A조（ABI＜0．9，106례）여B조（ABI≥0．9，102례），비교량조환자관맥병변엄중정도급주요심장불량사건（MACE）발생솔。【결과】A조적관맥엄중（삼지）병변환자급MACE발생솔명현다우B조（ P ＜0．01）。ABI치여관상동맥병변수량정현저부상관（ r ＝－0．627，P ＜0．01）。재조정료림상자료급혈당등영향인소후，ABI＜0．9재당뇨병수시인군중예측관상엄중（삼지）적민감성위66．7％，특이성위92．5％，준학도위90．5％（OR치17．171，95％가신구간분별위：4．069～22．456，P＜0．01）。평개ABI대관상엄중（삼지）병변예측개치적ROC곡선하면적위（0．825±0．42），95％가신구간위（0．743～0．907）（ P ＜0．01），기중이ABI＝0．84위최가예측림계점（민도위67％，특이도위93％，Youden지수최고위0．601）。【결론】ABI작위하지동맥죽양경화무창감측수단，대2형당뇨병환자관맥병변정도유일정예측개치，가용우식별관심병고위환자。
[Objective] To explore the relevance of ankle brachial index and the severity of coronary artery le‐sion in type 2 diabetes mellitus (T2DM ) patients .[Methods]A total of 208 T2DM patients were recruited and di‐vided into two groups according to ABI level ,i .e .group A (ABI<0 .9 ,n=106) and group B (ABI ≥0 .9 ,n =102) .The clinical data including the severity of coronary artery lesion ,incidence of major adverse cardiovascular e‐vent (MACE) and ABI were recorded and analyzed .[Results] The incidences of coronary artery disease (CAD) , especially in complex lesions and MACE were much higher in group A than those in group B ( P<0 .01) .ABI had a negative correlation with the number of coronary artery lesions ( r = -0 .627 ,P <0 .01) and it was associated with a specificity of 92 .5% and a sensitivity of 66 .7% for predicting the presence of CAD complex lesions .Logis‐tic regression revealed that after adjusting for blood sugar ,HbA1C ,lipid ,age and gender ,ABI <0 .9 was still a significant predictor for complex lesions in T2DM patients with an odds ratio (OR) of 17 .171 (95% CI 4 .069~22 .456 ,P <0 .01) .The corresponding area under the ROC curve was 0 .825 ± 0 .42 with a 95% confidence inter‐val (CI) of 0 .743 to 0 .907 ( P <0 .01) .And ABI= 0 .84 was the optimal point of predicting with the highest Youden index (0 .601) .[Conclusion] ABI may be a simple ,inexpensive and useful noninvasive tool for predicting CAD and the extent of coronary artery lesion in T 2DM patients .